Provider Demographics
NPI:1720328164
Name:REACHING FOR SUCCESS XOUNSELING SERVICE
Entity Type:Organization
Organization Name:REACHING FOR SUCCESS XOUNSELING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:504-994-2012
Mailing Address - Street 1:PO BOX 7792
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70010-7792
Mailing Address - Country:US
Mailing Address - Phone:504-832-4989
Mailing Address - Fax:504-831-7712
Practice Address - Street 1:827 SOUTH CAUSEWAY BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70121
Practice Address - Country:US
Practice Address - Phone:504-832-4989
Practice Address - Fax:504-831-7712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332B00000X, 332BC3200X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2117653Medicaid
LA2117505Medicaid
LA2117491Medicaid
LA2117483Medicaid