| Innis Community Health Center, Inc | |
|
13258 La Highway 416 Rougon LA 70773 | |
| (225) 627-4291 | |
| Not Available |
| Full Name | Innis Community Health Center, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 13258 La Highway 416, Rougon, Louisiana |
| Authorized Official Name and Position | Cindy Peavy (EXEUTIVE 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: () - | Innis Community Health Center, Inc 13258 La Highway 416 Rougon LA 70773 Ph: (225) 627-4291 |
| NPI Number | 1780059162 |
|---|---|
| Provider Enumeration Date | 12/10/2015 |
| Last Update Date | 11/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780059162 | NPI | - | NPPES |
| 2408135 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |