| Tioga Junior High Sbhc | |
|
1150 Junior High Road Pineville LA 71360 | |
| (318) 640-6942 | |
| (318) 640-6978 |
| Full Name | Tioga Junior High Sbhc |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 1150 Junior High Road, 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 |
|---|---|
| Tioga Junior High Sbhc 3330 Masonic Dr Alexandria LA 71301-3841 Ph: (318) 483-4031 | Tioga Junior High Sbhc 1150 Junior High Road Pineville LA 71360 Ph: (318) 640-6942 |
| NPI Number | 1649391079 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 10/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649391079 | NPI | - | NPPES |
| 1446912 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | 234 (Louisiana) | Primary |
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