Provider Demographics
NPI:1689496614
Name:THE GUILD AT RAPHAEL VILLAGE LLC
Entity type:Organization
Organization Name:THE GUILD AT RAPHAEL VILLAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-524-5955
Mailing Address - Street 1:517 SORAPARU ST APT 104
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-2001
Mailing Address - Country:US
Mailing Address - Phone:504-628-6876
Mailing Address - Fax:
Practice Address - Street 1:530 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-4812
Practice Address - Country:US
Practice Address - Phone:504-524-5955
Practice Address - Fax:504-482-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health