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General NPI Number Information
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NPI Number | 1750444659
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Entity Type | Organization
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Legal Business Name | ST. FRANCIS HEALTHY KIDS CLINIC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 850 S 2ND ST
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City | MONROE
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State | LA
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Zip | 71202-2112
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Country | US
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Telephone | 318-327-7368
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Fax | 318-327-7359
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Provider Business Mailing Address
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Address Line | 309 JACKSON ST
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City | MONROE
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State | LA
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Zip | 71201-7407
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Country | US
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Telephone | 318-327-7367
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Fax | 318-327-7359
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Authorized Official
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Title or Position | SR. VICE PRESIDENT AND CFO
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Name | MR. RONALD E HOGAN
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Credential |
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Telephone | 318-327-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 157
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License Number State | LA
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