Healthcare Provider Details

I. General information

NPI: 1982017273
Provider Name (Legal Business Name): FAMILY HEALTHCARE OF BEAUREGARD, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 06/07/2025
Certification Date: 06/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W 8TH ST
DERIDDER LA
70634-5507
US

IV. Provider business mailing address

PO BOX 935
DERIDDER LA
70634-0935
US

V. Phone/Fax

Practice location:
  • Phone: 337-463-8977
  • Fax: 337-462-3093
Mailing address:
  • Phone: 337-463-8977
  • Fax: 337-462-3093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JARRED VEILLON
Title or Position: CFO
Credential:
Phone: 337-462-7409