Healthcare Provider Details
I. General information
NPI: 1720054075
Provider Name (Legal Business Name): TENSAS COMMUNITY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2006
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date: 08/23/2018
Reactivation Date: 12/12/2018
III. Provider practice location address
402 LEVEE RD
SAINT JOSEPH LA
71366-6661
US
IV. Provider business mailing address
402 LEVEE RD
SAINT JOSEPH LA
71366-6661
US
V. Phone/Fax
- Phone: 318-766-1967
- Fax: 318-766-9090
- Phone: 318-766-1967
- Fax: 318-766-9090
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | LA |
VIII. Authorized Official
Name: MRS.
JACQUELINE
SCHAUF
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 318-766-1967