| Innis Community Health Center, Inc | |
|
8387 Newfield Dr Livonia LA 70755-3605 | |
| (225) 412-0202 | |
| (225) 412-0366 |
| Full Name | Innis Community Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8387 Newfield Dr, Livonia, Louisiana |
| Authorized Official Name and Position | Cindy Peavy (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2254923775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innis Community Health Center, Inc 6450 Louisiana Highway 1 Batchelor LA 70715 Ph: (225) 492-3775 | Innis Community Health Center, Inc 8387 Newfield Dr Livonia LA 70755-3605 Ph: (225) 412-0202 |
| NPI Number | 1003910167 |
|---|---|
| Provider Enumeration Date | 09/11/2006 |
| Last Update Date | 11/18/2021 |
| Medicare PECOS PAC ID | 9931130358 |
|---|---|
| Medicare Enrollment ID | O20051122000008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003910167 | NPI | - | NPPES |
| 1450618 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Innis Community Health Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3118 La Highway 78, Livonia, LA 70755 Phone: 225-637-2532 | |
Innis Community Health Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8737 Newfield Drive, Livonia, LA 70755 Phone: 225-637-2323 Fax: 225-637-2327 |