Provider Demographics
NPI:1366102543
Name:FLORENSON HEALTHCARE DETOX FACILITY
Entity type:Organization
Organization Name:FLORENSON HEALTHCARE DETOX FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHIGBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-236-8396
Mailing Address - Street 1:6306 ST CLAUDE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-1454
Mailing Address - Country:US
Mailing Address - Phone:504-582-9840
Mailing Address - Fax:504-841-9668
Practice Address - Street 1:2235 POYDRA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119
Practice Address - Country:US
Practice Address - Phone:504-582-9840
Practice Address - Fax:504-841-9668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility