Provider Demographics
NPI:1851089460
Name:REBUILDING DREAMS AND EMPOWERING CHANGE
Entity Type:Organization
Organization Name:REBUILDING DREAMS AND EMPOWERING CHANGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:JHAN
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW-BACS
Authorized Official - Phone:504-909-7376
Mailing Address - Street 1:303 S BROAD ST FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6415
Mailing Address - Country:US
Mailing Address - Phone:504-909-7376
Mailing Address - Fax:
Practice Address - Street 1:303 S BROAD ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6415
Practice Address - Country:US
Practice Address - Phone:504-909-7376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty