Provider Demographics
NPI:1184154858
Name:THE GUILD AT RAPHAEL VILLAGE LLC
Entity type:Organization
Organization Name:THE GUILD AT RAPHAEL VILLAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-628-6876
Mailing Address - Street 1:517 SORAPARU ST APT 104
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-2001
Mailing Address - Country:US
Mailing Address - Phone:504-628-6876
Mailing Address - Fax:
Practice Address - Street 1:500 SORAPARU STREET
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130
Practice Address - Country:US
Practice Address - Phone:504-524-5955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAPHAEL VILLAGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-15
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care