Provider Demographics
NPI:1982823480
Name:CITY NEW ORLEANS HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:CITY NEW ORLEANS HEALTH DEPARTMENT
Other - Org Name:MC DONOGH 35 SCHOOL BASE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EVANGELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-658-2513
Mailing Address - Street 1:1331 KERLEREC ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70116-1819
Mailing Address - Country:US
Mailing Address - Phone:504-940-4249
Mailing Address - Fax:504-940-4249
Practice Address - Street 1:1331 KERLEREC ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70116-1819
Practice Address - Country:US
Practice Address - Phone:504-940-4249
Practice Address - Fax:504-940-4249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QP0905X261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1446173Medicaid