Provider Demographics
NPI:1730312026
Name:IN THIS TOGETHER
Entity Type:Organization
Organization Name:IN THIS TOGETHER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HICKERSON MSW
Authorized Official - Last Name:HICKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW RSW
Authorized Official - Phone:504-962-3245
Mailing Address - Street 1:2511 BAYOU RD STE B
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-2302
Mailing Address - Country:US
Mailing Address - Phone:504-962-3245
Mailing Address - Fax:
Practice Address - Street 1:2511 BAYOU RD STE B
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-2302
Practice Address - Country:US
Practice Address - Phone:504-962-3245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1030121251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1310121Medicaid