Healthcare Provider Details

I. General information

NPI: 1013845882
Provider Name (Legal Business Name): COUSHATTA TRIBE OF LOUISIANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

287 PANTHER TRAIL
KINDER LA
70648
US

IV. Provider business mailing address

2003 C C BEL RD
ELTON LA
70532-5318
US

V. Phone/Fax

Practice location:
  • Phone: 337-738-4340
  • Fax:
Mailing address:
  • Phone: 337-584-1439
  • Fax: 337-584-1473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAULA MANUEL
Title or Position: HEALTH DIRECTOR
Credential:
Phone: 337-584-1439