Healthcare Provider Details

I. General information

NPI: 1366626574
Provider Name (Legal Business Name): WEST JEFFERSON SCHOOL BASED HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2007
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 8TH ST
HARVEY LA
70058-4006
US

IV. Provider business mailing address

822 S CLEARVIEW PKWY
HARAHAN LA
70123-3401
US

V. Phone/Fax

Practice location:
  • Phone: 504-367-4407
  • Fax: 504-367-4327
Mailing address:
  • Phone: 504-348-9899
  • Fax: 504-349-8985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateLA

VIII. Authorized Official

Name: MRS. BELINDA BENOIT SCHOUEST
Title or Position: DATA COORDINATOR
Credential:
Phone: 504-349-8996