Healthcare Provider Details

I. General information

NPI: 1245709658
Provider Name (Legal Business Name): TOLEDO HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11340 TEXAS HWY
MANY LA
71449
US

IV. Provider business mailing address

11340 TEXAS HWY
MANY LA
71449-5611
US

V. Phone/Fax

Practice location:
  • Phone: 318-315-0574
  • Fax:
Mailing address:
  • Phone: 318-508-5323
  • Fax: 318-508-5328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELISSA BRANCH VINES
Title or Position: MANAGER/FNP
Credential: FNP
Phone: 318-508-5323