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General NPI Number Information
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NPI Number | 1871065516
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Entity Type | Organization
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Legal Business Name | CLHG-LEESVILLE
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Dates
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Enumeration Date | 12/19/2018
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 506 S 6TH ST
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City | LEESVILLE
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State | LA
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Zip | 71446-4482
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Country | US
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Telephone | 337-239-0989
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Fax | 337-392-9383
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Provider Business Mailing Address
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Address Line | 1020 W FERTITTA BLVD
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City | LEESVILLE
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State | LA
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Zip | 71446-4645
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Country | US
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Telephone | 318-239-9041
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Fax | 318-239-5360
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Authorized Official
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Title or Position | BOARD MEMBER
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Name | DONALD E. CAMERON
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Credential |
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Telephone | 318-226-8202
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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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