| Penn 123 Llc | |
|
4933 Wabash St Metairie LA 70001-1031 | |
| (504) 603-3060 | |
| Not Available |
| Full Name | Penn 123 Llc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 4933 Wabash St, Metairie, Louisiana |
| Authorized Official Name and Position | Yehuda Alter (CEO) |
| Authorized Official Contact | 7323078000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Penn 123 Llc 211 Boulevard Of The Americas Suite 503 Lakewood NJ 08701 Ph: (732) 307-8000 | Penn 123 Llc 4933 Wabash St Metairie LA 70001-1031 Ph: (504) 603-3060 |
| NPI Number | 1144915786 |
|---|---|
| Provider Enumeration Date | 04/10/2023 |
| Last Update Date | 04/10/2023 |
| Certification Date | 03/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144915786 | NPI | - | NPPES |
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