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General NPI Number Information
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NPI Number | 1205930450
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Entity Type | Organization
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Legal Business Name | CLHG-OAKDALE, LLC
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Dates
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Enumeration Date | 09/09/2006
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 504 WEST MAIN
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City | OAKDALE
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State | LA
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Zip | 70638-0001
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Country | US
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Telephone | 318-634-5475
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Fax | 318-634-5161
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Provider Business Mailing Address
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Address Line | PO BOX 629
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City | OAKDALE
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State | LA
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Zip | 71463-0629
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Country | US
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Telephone | 318-335-3700
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Fax | 318-215-3024
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Authorized Official
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Title or Position | ASST. CHIEF FINANCIAL OFFICER
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Name | SUZETTE FATULA
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Credential |
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Telephone | 318-215-3223
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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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