Provider Demographics
NPI:1932393477
Name:THE NEW YOU REINTEGRATION PROJECT
Entity Type:Organization
Organization Name:THE NEW YOU REINTEGRATION PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELISKA
Authorized Official - Middle Name:F
Authorized Official - Last Name:ETIENNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-769-4611
Mailing Address - Street 1:7354 ALBERTA DR STE D
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4192
Mailing Address - Country:US
Mailing Address - Phone:225-769-4611
Mailing Address - Fax:225-769-4601
Practice Address - Street 1:7354 ALBERTA DR STE D
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4192
Practice Address - Country:US
Practice Address - Phone:225-769-4611
Practice Address - Fax:225-769-4601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE NEW YOU REINTEGRATION PROJECT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1776122Medicaid