Provider Demographics
NPI:1851729990
Name:DUVAL LANGSTON
Entity Type:Organization
Organization Name:DUVAL LANGSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRICE
Authorized Official - Middle Name:TINA
Authorized Official - Last Name:LAIN
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:504-241-8188
Mailing Address - Street 1:1734 GALLIER ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-6032
Mailing Address - Country:US
Mailing Address - Phone:504-256-4836
Mailing Address - Fax:
Practice Address - Street 1:9235 LAKE FOREST BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3043
Practice Address - Country:US
Practice Address - Phone:504-241-8188
Practice Address - Fax:504-264-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health