Healthcare Provider Details

I. General information

NPI: 1811436058
Provider Name (Legal Business Name): CLHG-WINN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W BOUNDARY AVE STE B
WINNFIELD LA
71483-3427
US

IV. Provider business mailing address

301 W BOUNDARY AVE
WINNFIELD LA
71483-3427
US

V. Phone/Fax

Practice location:
  • Phone: 318-209-4646
  • Fax: 318-209-4649
Mailing address:
  • Phone: 318-648-3000
  • Fax: 318-628-2035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MONICA LEWIS
Title or Position: CEO
Credential:
Phone: 318-224-3589