| David Raines Community Health Center | |
|
1625 David Raines Rd Shreveport LA 71107-5899 | |
| (318) 425-2252 | |
| (318) 227-3357 |
| Full Name | David Raines Community Health Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1625 David Raines Rd, Shreveport, Louisiana |
| Authorized Official Name and Position | Willie C White (CEO) |
| Authorized Official Contact | 3184252252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David Raines Community Health Center 1625 David Raines Rd Shreveport LA 71107-5899 Ph: (318) 425-2252 | David Raines Community Health Center 1625 David Raines Rd Shreveport LA 71107-5899 Ph: (318) 425-2252 |
| NPI Number | 1932369535 |
|---|---|
| Provider Enumeration Date | 06/17/2008 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932369535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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