Basic Information
| Provider Information | |||||||||
| NPI: | 1346908316 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | POSITIVE DIRECTION SUPPORT SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 88 LAKE ELIZABETH CT | ||||||||
| Address2: | |||||||||
| City: | HARVEY | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700586512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5043901188 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1995 GENTILLY BLVD STE C-400 | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701191700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049440453 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2021 | ||||||||
| LastUpdateDate: | 12/07/2021 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | ALEAH | ||||||||
| AuthorizedOfficialMiddleName: | CI'MONE | ||||||||
| AuthorizedOfficialTitleorPosition: | MENTAL HEALTH SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 5049440453 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.