| Village Of Hope Inc | |
|
3198 Terrace Ave Slidell LA 70458-4500 | |
| (903) 265-8061 | |
| Not Available |
| Full Name | Village Of Hope Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3198 Terrace Ave, Slidell, Louisiana |
| Authorized Official Name and Position | Latoyia Ibrahim (DIRECTOR) |
| Authorized Official Contact | 9032658061 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Of Hope Inc 3198 Terrace Ave Slidell LA 70458-4500 Ph: (903) 265-8061 | Village Of Hope Inc 3198 Terrace Ave Slidell LA 70458-4500 Ph: (903) 265-8061 |
| NPI Number | 1982480588 |
|---|---|
| Provider Enumeration Date | 09/07/2023 |
| Last Update Date | 08/19/2024 |
| Certification Date | 08/19/2024 |
| Medicare PECOS PAC ID | 9234679721 |
|---|---|
| Medicare Enrollment ID | O20240911001753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982480588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Dominique Ganier Dorsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578193603 PECOS PAC ID: 2769867118 Enrollment ID: I20240912004526 |
| Provider Name | Lynn Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659503712 PECOS PAC ID: 4284865767 Enrollment ID: I20250117000654 |
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