Provider Demographics
NPI:1013463835
Name:DAUGHTERS OF CHARITY
Entity Type:Organization
Organization Name:DAUGHTERS OF CHARITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MATERNAL-CHILD NURSE
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:817-915-2968
Mailing Address - Street 1:7614 FORUM BLVD.
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2112
Mailing Address - Country:US
Mailing Address - Phone:817-915-2968
Mailing Address - Fax:
Practice Address - Street 1:3201 S CARROLLTON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-4307
Practice Address - Country:US
Practice Address - Phone:504-207-3060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA059097261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service