Healthcare Provider Details

I. General information

NPI: 1174579262
Provider Name (Legal Business Name): TECHE ACTION BOARD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 WEBER ST
FRANKLIN LA
70538-4124
US

IV. Provider business mailing address

1115 WEBER ST
FRANKLIN LA
70538-4124
US

V. Phone/Fax

Practice location:
  • Phone: 337-828-2550
  • Fax: 337-355-2335
Mailing address:
  • Phone: 337-828-2550
  • Fax: 337-355-2335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number04402470N
License Number StateLA

VIII. Authorized Official

Name: GARY M WILTZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.D.
Phone: 337-828-2550