| |
3118 La Highway 78 Livonia LA 70755 | |
(225) 637-2532 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 3118 La Highway 78, Livonia, Louisiana |
Authorized Official Name and Position | Cindy Peavy (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2254923775 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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6450 Louisiana Highway 1 Batchelor LA 70715 Ph: () - | 3118 La Highway 78 Livonia LA 70755 Ph: (225) 637-2532 |
NPI Number | 1184099574 |
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Provider Enumeration Date | 12/10/2015 |
Last Update Date | 11/18/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184099574 | NPI | - | NPPES |
2409816 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |