Provider Demographics
NPI:1922512326
Name:CREED GROUP OF LOUISIANA LLC
Entity Type:Organization
Organization Name:CREED GROUP OF LOUISIANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-814-8001
Mailing Address - Street 1:2235 POYDRAS ST STE A
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7561
Mailing Address - Country:US
Mailing Address - Phone:504-814-8001
Mailing Address - Fax:
Practice Address - Street 1:2235 POYDRAS ST STE A
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7561
Practice Address - Country:US
Practice Address - Phone:504-814-8001
Practice Address - Fax:504-814-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty