| Clhg-dequincy, Llc | |
|
110 W 4th St Dequincy LA 70633-3508 | |
| (337) 786-1200 | |
| (337) 786-1219 |
| Full Name | Clhg-dequincy, Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 110 W 4th St, Dequincy, Louisiana |
| Authorized Official Name and Position | Jeried H. Hairgrove (CEO-ADMINISTRATOR) |
| Authorized Official Contact | 3373755997 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clhg-dequincy, Llc Po Box 1166 Dequincy LA 70633-1166 Ph: (337) 786-1200 | Clhg-dequincy, Llc 110 W 4th St Dequincy LA 70633-3508 Ph: (337) 786-1200 |
| NPI Number | 1538722285 |
|---|---|
| Provider Enumeration Date | 04/18/2019 |
| Last Update Date | 04/18/2019 |
| Medicare PECOS PAC ID | 4385987106 |
|---|---|
| Medicare Enrollment ID | O20190520001171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538722285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
Dequincy Memorial Hospital Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 W 4th St, Dequincy, LA 70633 Phone: 337-786-2900 Fax: 337-786-1675 |