Provider Demographics
NPI:1790964542
Name:IN THIS TOGETHER, INC.
Entity Type:Organization
Organization Name:IN THIS TOGETHER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:504-962-3245
Mailing Address - Street 1:1661 CANAL ST
Mailing Address - Street 2:SUITE 3107
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2861
Mailing Address - Country:US
Mailing Address - Phone:504-962-3245
Mailing Address - Fax:504-962-3246
Practice Address - Street 1:1661 CANAL ST
Practice Address - Street 2:SUITE 3107
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2861
Practice Address - Country:US
Practice Address - Phone:504-962-3245
Practice Address - Fax:504-962-3246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACM 2324251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1623300Medicaid