| Northside Community Health Center | |
|
1800 Louisiana Ave Lafayette LA 70501-3702 | |
| (337) 942-3390 | |
| (337) 942-8644 |
| Full Name | Northside Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1800 Louisiana Ave, Lafayette, Louisiana |
| Authorized Official Name and Position | Dodie Lamott (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3379423390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northside Community Health Center Po Box 1815 Opelousas LA 70571-1815 Ph: (337) 942-3390 | Northside Community Health Center 1800 Louisiana Ave Lafayette LA 70501-3702 Ph: (337) 942-3390 |
| NPI Number | 1609120682 |
|---|---|
| Provider Enumeration Date | 10/30/2012 |
| Last Update Date | 04/28/2017 |
| Medicare PECOS PAC ID | 8628987682 |
|---|---|
| Medicare Enrollment ID | O20170630001104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609120682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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