| Lessie Moore Sbhc | |
|
207 Griffith St Pineville LA 71360-5267 | |
| (318) 487-9648 | |
| (318) 442-0769 |
| Full Name | Lessie Moore Sbhc |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 207 Griffith St, Pineville, Louisiana |
| Authorized Official Name and Position | Monte Wilson (CEO) |
| Authorized Official Contact | 3374702100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lessie Moore Sbhc 3330 Masonic Dr Alexandria LA 71301-3841 Ph: (318) 483-4031 | Lessie Moore Sbhc 207 Griffith St Pineville LA 71360-5267 Ph: (318) 487-9648 |
| NPI Number | 1023139458 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 10/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023139458 | NPI | - | NPPES |
| 1446858 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | 234 (Louisiana) | Primary |
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