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General NPI Number Information
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NPI Number | 1902309370
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Entity Type | Organization
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Legal Business Name | START CORPORATION
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Dates
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Enumeration Date | 03/13/2018
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Last Update Date | 11/28/2018
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Provider Practice Location Address
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Address Line | 1505 N FLORIDA ST
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City | COVINGTON
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State | LA
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Zip | 70433-1544
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Country | US
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Telephone | 985-900-1626
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Fax | 985-867-1768
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Provider Business Mailing Address
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Address Line | PO BOX 165
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City | HOUMA
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State | LA
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Zip | 70361-0165
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Country | US
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Telephone | 985-879-3966
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Fax | 985-872-4473
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | BARBARA STRAIN
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Credential | LPC
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Telephone | 985-900-1626
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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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