Provider Demographics
NPI:1821703455
Name:THE CREED GROUP OF LOUISIANA
Entity Type:Organization
Organization Name:THE CREED GROUP OF LOUISIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIGBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-236-8396
Mailing Address - Street 1:2235 POYDRAS ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7576
Mailing Address - Country:US
Mailing Address - Phone:504-236-8396
Mailing Address - Fax:504-814-8002
Practice Address - Street 1:2235 POYDRAS ST UNIT A
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7576
Practice Address - Country:US
Practice Address - Phone:504-236-8396
Practice Address - Fax:504-814-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0000000000Medicaid