Provider Demographics
NPI:1750660270
Name:COMMUNITY COMMITMENT
Entity Type:Organization
Organization Name:COMMUNITY COMMITMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER / CEO-DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:LETRICE
Authorized Official - Last Name:BOUIE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:504-931-0549
Mailing Address - Street 1:2219 DANTE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-2956
Mailing Address - Country:US
Mailing Address - Phone:504-931-0549
Mailing Address - Fax:504-861-0202
Practice Address - Street 1:8926 HICKORY ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-1446
Practice Address - Country:US
Practice Address - Phone:504-931-0549
Practice Address - Fax:504-861-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6170251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management