| |
13085 Chef Menteur Hwy New Orleans LA 70129-1804 | |
(504) 309-8390 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 13085 Chef Menteur Hwy, New Orleans, Louisiana |
Authorized Official Name and Position | Diem Nguyen (CEO) |
Authorized Official Contact | 5042558665 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4626 Alcee Fortier Blvd Suite E New Orleans LA 70129-2130 Ph: () - | 13085 Chef Menteur Hwy New Orleans LA 70129-1804 Ph: (504) 309-8390 |
NPI Number | 1649605973 |
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Provider Enumeration Date | 09/05/2013 |
Last Update Date | 12/11/2014 |
Identifier | Type | State | Issuer |
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1649605973 | NPI | - | NPPES |
2348663 | Medicaid | LA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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