| David Raines School Based Health Center - Linwood | |
|
401 W 70th St Shreveport LA 71106-3034 | |
| (318) 227-3350 | |
| Not Available |
| Full Name | David Raines School Based Health Center - Linwood |
|---|---|
| Speciality | Clinic/Center |
| Location | 401 W 70th St, Shreveport, Louisiana |
| Authorized Official Name and Position | Willie C. White (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3182273350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David Raines School Based Health Center - Linwood 3041 Martin Luther King Drive Shreveport LA 71107-4705 Ph: (318) 227-3350 | David Raines School Based Health Center - Linwood 401 W 70th St Shreveport LA 71106-3034 Ph: (318) 227-3350 |
| NPI Number | 1760904981 |
|---|---|
| Provider Enumeration Date | 07/10/2017 |
| Last Update Date | 07/10/2017 |
| Medicare PECOS PAC ID | 4688586118 |
|---|---|
| Medicare Enrollment ID | O20231114003529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760904981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Louisiana) | Primary |
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