Healthcare Provider Details

I. General information

NPI: 1952941767
Provider Name (Legal Business Name): BAPTIST COMMUNITY HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 W CAUSEWAY APPROACH
MANDEVILLE LA
70471-3045
US

IV. Provider business mailing address

4960 SAINT CLAUDE AVE
NEW ORLEANS LA
70117-4258
US

V. Phone/Fax

Practice location:
  • Phone: 504-533-4999
  • Fax:
Mailing address:
  • Phone: 504-704-5949
  • Fax: 504-704-5989

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: PHILLIP D BRODT
Title or Position: CEO
Credential:
Phone: 504-533-4999