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General NPI Number Information
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NPI Number | 1871584722
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Entity Type | Organization
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Legal Business Name | CHRISTUS HEALTH CENTRAL LOUISIANA
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 1633 MARVEL STREET
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City | COUSHATTA
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State | LA
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Zip | 71019-9022
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Country | US
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Telephone | 318-932-2081
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Fax | 318-932-2215
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Provider Business Mailing Address
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Address Line | PO BOX 847329
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City | DALLAS
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State | TX
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Zip | 75284-7329
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Country | US
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Telephone | 800-756-7999
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Fax | 469-282-1791
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Authorized Official
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Title or Position | CEO
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Name | MONTE WILSON
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Credential |
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Telephone | 337-470-2100
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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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Taxonomy #2
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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License Number | 551RHC-1
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License Number State | LA
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