Basic Information
| Provider Information | |||||||||
| NPI: | 1043684343 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | POSITIVE DIRECTION SUPPORT SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1995 GENTILLY BLVD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701191700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049440453 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1995 GENTILLY BLVD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701191700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049440453 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2015 | ||||||||
| LastUpdateDate: | 11/24/2015 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | BARBARA | ||||||||
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| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5049440453 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.