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General NPI Number Information
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NPI Number | 1821871112
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Entity Type | Organization
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Legal Business Name | INNIS COMMUNITY HEALTH CENTER, INC
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Dates
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Enumeration Date | 08/18/2023
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 337 NAPOLEON ST
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City | NEW ROADS
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State | LA
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Zip | 70760-3527
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Country | US
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Telephone | 225-618-5959
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Fax |
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Provider Business Mailing Address
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Address Line | 6450 LA HIGHWAY 1
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City | BATCHELOR
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State | LA
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Zip | 70715-3212
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Country | US
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Telephone | 225-492-3775
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Fax | 225-492-3782
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Authorized Official
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Title or Position | CREDENTIALING/BILLING SUPERVISOR
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Name | KAYCE PICARD
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Credential |
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Telephone | 225-492-3775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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