| Chitimacha Tribe Of Louisiana | |
|
3231 Chitimacha Trail Charenton LA 70523-0661 | |
| (337) 923-9955 | |
| (337) 923-6848 |
| Full Name | Chitimacha Tribe Of Louisiana |
|---|---|
| Speciality | Clinic/Center |
| Location | 3231 Chitimacha Trail, Charenton, Louisiana |
| Authorized Official Name and Position | Tricia Lynn Mora (DIRECTOR HEALTH AND HUMAN SERVICES) |
| Authorized Official Contact | 3379239955 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chitimacha Tribe Of Louisiana Po Box 640 Charenton LA 70523-0640 Ph: (337) 923-9955 | Chitimacha Tribe Of Louisiana 3231 Chitimacha Trail Charenton LA 70523-0661 Ph: (337) 923-9955 |
| NPI Number | 1154477909 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 06/20/2013 |
| Medicare PECOS PAC ID | 5496645335 |
|---|---|
| Medicare Enrollment ID | O20040316000965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154477909 | NPI | - | NPPES |
| 1233978 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 15134R (Louisiana) | Primary |
| Provider Name | Charles R Parsiola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841281490 PECOS PAC ID: 2365434248 Enrollment ID: I20120531000402 |
| Provider Name | Alexi Plaisance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265881379 PECOS PAC ID: 0042566283 Enrollment ID: I20201022000901 |