Healthcare Provider Details

I. General information

NPI: 1154063055
Provider Name (Legal Business Name): START CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 N 17TH ST
BATON ROUGE LA
70802-3800
US

IV. Provider business mailing address

PO BOX 165
HOUMA LA
70361-0165
US

V. Phone/Fax

Practice location:
  • Phone: 225-388-5800
  • Fax:
Mailing address:
  • Phone: 985-333-2020
  • Fax:

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: CATHERINE FELARISE
Title or Position: VICE PRESIDENT
Credential:
Phone: 985-333-2020