Provider Demographics
NPI:1770114217
Name:CORE LOUISIANA COUNSELING & RECOVERY CENTER, LLC
Entity type:Organization
Organization Name:CORE LOUISIANA COUNSELING & RECOVERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDIN MURO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:504-656-4325
Mailing Address - Street 1:4534 OWENS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-1223
Mailing Address - Country:US
Mailing Address - Phone:504-234-2001
Mailing Address - Fax:
Practice Address - Street 1:306 W JUDGE PEREZ DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-4904
Practice Address - Country:US
Practice Address - Phone:504-656-4325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty