Provider Demographics
NPI:1982081337
Name:CATHOLIC CHARITIES ARCHDIOCESE OF NEW ORLEANS
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES ARCHDIOCESE OF NEW ORLEANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTANZA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:504-874-7829
Mailing Address - Street 1:1000 HOWARD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113-1903
Mailing Address - Country:US
Mailing Address - Phone:504-874-7829
Mailing Address - Fax:504-596-3098
Practice Address - Street 1:100 MELONIE ST
Practice Address - Street 2:SUITE F
Practice Address - City:BOUTTE
Practice Address - State:LA
Practice Address - Zip Code:70039-3052
Practice Address - Country:US
Practice Address - Phone:985-785-2113
Practice Address - Fax:985-785-2198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLPC #6185251S00000X
LANCC #349282251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health