Provider Demographics
NPI:1174743900
Name:COMPREHENSIVE SOCIAL RESOURCES LTD
Entity type:Organization
Organization Name:COMPREHENSIVE SOCIAL RESOURCES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELPHINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-466-6067
Mailing Address - Street 1:819 VETERANS BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70062-5172
Mailing Address - Country:US
Mailing Address - Phone:504-466-6067
Mailing Address - Fax:504-466-6068
Practice Address - Street 1:819 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-5172
Practice Address - Country:US
Practice Address - Phone:504-466-6067
Practice Address - Fax:504-466-6068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA6808305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1174955Medicaid
LA1556874Medicaid