Healthcare Provider Details

I. General information

NPI: 1275754582
Provider Name (Legal Business Name): JEFFERSON PARISH SCHOOL BASED HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FOURTH ST
WESTWEGO LA
70094-4335
US

IV. Provider business mailing address

8101 SIMON ST
METAIRIE LA
70003-6427
US

V. Phone/Fax

Practice location:
  • Phone: 504-341-0645
  • Fax: 504-341-0689
Mailing address:
  • Phone: 504-737-5523
  • Fax: 504-737-2649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number StateLA

VIII. Authorized Official

Name: MRS. BELINDA BENOIT SCHOUEST
Title or Position: SECRETARY
Credential:
Phone: 504-341-0645