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General NPI Number Information
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NPI Number | 1164073524
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Entity Type | Organization
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Legal Business Name | TANGI WELLNESS & HEALTH
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Dates
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Enumeration Date | 09/26/2019
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Last Update Date | 01/16/2020
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Provider Practice Location Address
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Address Line | 906 C M FAGAN DR STE B3
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City | HAMMOND
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State | LA
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Zip | 70403-6056
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Country | US
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Telephone | 985-345-1555
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Fax | 985-345-1558
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Provider Business Mailing Address
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Address Line | 906 C M FAGAN DR STE B3
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City | HAMMOND
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State | LA
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Zip | 70403-6056
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Country | US
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Telephone | 985-345-1555
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Fax | 985-345-1558
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | KELLY OLLER
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Credential |
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Telephone | 985-345-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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