Provider Demographics
NPI:1609015841
Name:BEHAVIORAL HEALTH & HUMAN DEVELOPMENT CENTER
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH & HUMAN DEVELOPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:REINOSO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:504-454-3015
Mailing Address - Street 1:4517 LORINO ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2323
Mailing Address - Country:US
Mailing Address - Phone:504-454-3015
Mailing Address - Fax:
Practice Address - Street 1:4517 LORINO ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2323
Practice Address - Country:US
Practice Address - Phone:504-454-3015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA753103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty