Provider Demographics
NPI:1760843361
Name:SHARED HEARTS MENTAL HEALTH COMPANY
Entity Type:Organization
Organization Name:SHARED HEARTS MENTAL HEALTH COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERMAINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:504-758-3114
Mailing Address - Street 1:4480 GEN DEGAULLE DR STE 206
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-6309
Mailing Address - Country:US
Mailing Address - Phone:504-758-3114
Mailing Address - Fax:
Practice Address - Street 1:4480 GEN DEGAULLE DR STE 206
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-6309
Practice Address - Country:US
Practice Address - Phone:504-758-3114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty