Healthcare Provider Details

I. General information

NPI: 1861904179
Provider Name (Legal Business Name): TENSAS COMMUNITY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 04/30/2020
Certification Date: 04/30/2020
Deactivation Date: 08/23/2018
Reactivation Date: 09/28/2018

III. Provider practice location address

916 PLANK ROAD
SAINT JOSEPH LA
71366
US

IV. Provider business mailing address

PO BOX 46
SAINT JOSEPH LA
71366-0046
US

V. Phone/Fax

Practice location:
  • Phone: 318-766-1967
  • Fax: 318-766-9090
Mailing address:
  • Phone: 318-766-1967
  • Fax: 318-766-9090

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: JACQUELINE SCHAUF
Title or Position: CEO
Credential:
Phone: 318-766-1967