| St Gabriel Health Clinic Inc | |
|
3285 Highway 75 Saint Gabriel LA 70776-4409 | |
| (225) 642-9676 | |
| (225) 642-9696 |
| Full Name | St Gabriel Health Clinic Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3285 Highway 75, Saint Gabriel, Louisiana |
| Authorized Official Name and Position | Shirley Freeman Wade (CEO) |
| Authorized Official Contact | 2256429676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Gabriel Health Clinic Inc Po Box 209 Saint Gabriel LA 70776-0209 Ph: (225) 642-3676 | St Gabriel Health Clinic Inc 3285 Highway 75 Saint Gabriel LA 70776-4409 Ph: (225) 642-9676 |
| NPI Number | 1922279843 |
|---|---|
| Provider Enumeration Date | 03/19/2008 |
| Last Update Date | 10/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922279843 | NPI | - | NPPES |
| 1457680 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
St Gabriel Health Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1825 Highway 30, Saint Gabriel, LA 70776 Phone: 225-642-9676 Fax: 225-642-9696 |