Provider Demographics
NPI:1699185710
Name:COURTESY GROWS LLC
Entity Type:Organization
Organization Name:COURTESY GROWS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-265-9957
Mailing Address - Street 1:2601 N HULLEN ST
Mailing Address - Street 2:STE 102&102C
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-5900
Mailing Address - Country:US
Mailing Address - Phone:504-265-9957
Mailing Address - Fax:504-342-2719
Practice Address - Street 1:2601 N HULLEN ST
Practice Address - Street 2:STE 102&102C
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-5900
Practice Address - Country:US
Practice Address - Phone:504-265-9957
Practice Address - Fax:504-342-2719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5363251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health