Provider Demographics
NPI:1922499359
Name:THE CITY OF NEW ORLEANS-HEALTH CARE FOR THE HOMELESS
Entity Type:Organization
Organization Name:THE CITY OF NEW ORLEANS-HEALTH CARE FOR THE HOMELESS
Other - Org Name:COMMUNITY RESOURCE AND REFERRAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM HCH EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BARTHE'-PREVOST
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:504-658-2529
Mailing Address - Street 1:2222 SIMON BOLIVAR AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113-1460
Mailing Address - Country:US
Mailing Address - Phone:504-658-2787
Mailing Address - Fax:504-658-2874
Practice Address - Street 1:1530 GRAVIER ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2104
Practice Address - Country:US
Practice Address - Phone:504-658-2785
Practice Address - Fax:504-658-2874
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CITY OF NEW ORLEANS HEALTH DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2377922Medicaid