NPIMap

Organization Active NPI

Exxodus Foundation Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • New Orleans, LA
National Provider Identifier
1164618534
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
LA0974029834 Issued in LA
Legal business name
EXXODUS FOUNDATION INC
Practice address
21 English Turn Dr
Suite a
New Orleans, LA 70131-3308
Phone
(504) 392-0272
Fax
(504) 392-0274
NPI assigned
Sep 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Renea Anne Robertson, BS.,MS.,ESQ.,
Title
Ceo., Pres., Executive Dir., Trust.
Phone
(504) 392-0272

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X LA0974029834 LA Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X LA9837472386 LA

Addresses

Primary practice location

21 English Turn Dr
Suite a
New Orleans, LA 70131-3308

Mailing address

21 English Turn Dr
Suite a
New Orleans, LA 70131-3308
Phone (504) 392-0272

Other identifiers 4

IdentifierTypeStateIssuer
LA12345678MedicaidLA
LA28176543MedicaidLA
LA9488487737MedicaidLA
LA2019837465MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1164618534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 ENGLISH TURN DR",
            "address_2": "SUITE A",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701313308",
            "telephone_number": "504-392-0272",
            "fax_number": "504-392-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 ENGLISH TURN DR",
            "address_2": "SUITE A",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701313308",
            "telephone_number": "504-392-0272",
            "fax_number": "504-392-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXXODUS FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "RENEA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CEO., PRES., EXECUTIVE DIR., TRUST.",
        "authorized_official_telephone_number": "504-392-0272",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BS.,MS.,ESQ.,"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "LA0974029834",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "LA9837472386",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LA12345678",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LA28176543",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LA9488487737",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LA2019837465",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.