Provider Demographics
NPI:1881975324
Name:THE JURON GROUP
Entity type:Organization
Organization Name:THE JURON GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JURON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:504-454-8400
Mailing Address - Street 1:4401 N I 10 SERVICE RD W
Mailing Address - Street 2:SUITE 104
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-6692
Mailing Address - Country:US
Mailing Address - Phone:504-454-8400
Mailing Address - Fax:504-454-8401
Practice Address - Street 1:4401 N I 10 SERVICE RD W
Practice Address - Street 2:SUITE 104
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-6692
Practice Address - Country:US
Practice Address - Phone:504-454-8400
Practice Address - Fax:504-454-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA112741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty