Healthcare Provider Details

I. General information

NPI: 1326953951
Provider Name (Legal Business Name): MARILLAC COMMUNITY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 W WATERMAN ST
DUMAS AR
71639-2139
US

IV. Provider business mailing address

PO BOX 13038
NEW ORLEANS LA
70185-3038
US

V. Phone/Fax

Practice location:
  • Phone: 870-382-3080
  • Fax: 870-382-4895
Mailing address:
  • Phone: 504-207-3060
  • Fax: 504-483-6016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL GRIFFIN
Title or Position: PRESIDENT - CEO
Credential:
Phone: 504-207-3060