| |
434 South St Paradis LA 70080-2244 | |
(985) 306-0414 | |
(504) 575-3691 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 434 South St, Paradis, Louisiana |
Authorized Official Name and Position | Mark Keiser (PRESIDENT) |
Authorized Official Contact | 5045753700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2900 Indiana Ave Kenner LA 70065-4605 Ph: (504) 575-3712 | 434 South St Paradis LA 70080-2244 Ph: (985) 306-0414 |
NPI Number | 1104239482 |
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Provider Enumeration Date | 06/04/2014 |
Last Update Date | 08/05/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104239482 | NPI | - | NPPES |
2370847 | Medicaid | LA |