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8387 Newfield Dr Livonia LA 70755-3605 | |
(225) 412-0202 | |
(225) 412-0366 |
Full Name | |
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Speciality | Clinic/Center |
Location | 8387 Newfield Dr, Livonia, Louisiana |
Authorized Official Name and Position | Cindy Peavy (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2254923775 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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6450 Louisiana Highway 1 Batchelor LA 70715 Ph: (225) 492-3775 | 8387 Newfield Dr Livonia LA 70755-3605 Ph: (225) 412-0202 |
NPI Number | 1003910167 |
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Provider Enumeration Date | 09/11/2006 |
Last Update Date | 11/18/2021 |
Medicare PECOS PAC ID | 9931130358 |
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Medicare Enrollment ID | O20051122000008 |
Identifier | Type | State | Issuer |
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1003910167 | NPI | - | NPPES |
1450618 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |