Healthcare Provider Details

I. General information

NPI: 1902309370
Provider Name (Legal Business Name): START CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2018
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 N FLORIDA ST
COVINGTON LA
70433-1544
US

IV. Provider business mailing address

PO BOX 165
HOUMA LA
70361-0165
US

V. Phone/Fax

Practice location:
  • Phone: 985-900-1626
  • Fax: 985-867-1768
Mailing address:
  • Phone: 985-879-3966
  • Fax: 985-872-4473

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: BARBARA STRAIN
Title or Position: PROGRAM DIRECTOR
Credential: LPC
Phone: 985-900-1626