| Innis Community Health Center, Inc | |
|
1100 New Roads St New Roads LA 70760-2300 | |
| (225) 638-6341 | |
| Not Available |
| Full Name | Innis Community Health Center, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1100 New Roads St, New Roads, Louisiana |
| Authorized Official Name and Position | Cindy Peavy (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2254923775 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| 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 1100 New Roads St New Roads LA 70760-2300 Ph: (225) 638-6341 |
| NPI Number | 1992170385 |
|---|---|
| Provider Enumeration Date | 12/10/2015 |
| Last Update Date | 03/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992170385 | NPI | - | NPPES |
| 2408101 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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