Healthcare Provider Details

I. General information

NPI: 1750573796
Provider Name (Legal Business Name): CENLA RURAL HEALTH CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 WEBB SMITH DR
COLFAX LA
71417-1910
US

IV. Provider business mailing address

PO BOX 148
COLFAX LA
71417-0148
US

V. Phone/Fax

Practice location:
  • Phone: 318-627-3700
  • Fax: 318-627-3545
Mailing address:
  • Phone: 318-627-3700
  • Fax: 318-627-3545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number022337LA
License Number StateLA

VIII. Authorized Official

Name: MS. SHEILA JAMIE THOMPSON
Title or Position: OFFICE MANGER
Credential:
Phone: 318-627-3700