MEDICARE: HEALTH CARE CENTER IN SCHOOLS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1649576588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH CARE CENTER IN SCHOOLS

Provider Business Mailing Address
First Line	:	PO BOX 64749
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70896-4749
Country	:	US
Telephone Number	:	225-343-9505
Fax Number	:

Provider Business Practice Location Address
First Line	:	4336 NORTH BLVD
Second Line	:	SUITE 201
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-3920
Country	:	US
Telephone Number	:	225-343-9505
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	JULIA J LIVELY
Credential	:
Telephone Number	:	225-343-9505

Provider Enumeration Date	:	02/09/2011
Last Update Date	:	02/09/2011

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