| Tioga Jr High Sbhc | |
|
1150 Tioga Rd Ball LA 71405-3978 | |
| (866) 530-6111 | |
| Not Available |
| Full Name | Tioga Jr High Sbhc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1150 Tioga Rd, Ball, Louisiana |
| Authorized Official Name and Position | Mark Keiser (CEO) |
| Authorized Official Contact | 5045753700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tioga Jr High Sbhc 2900 Indiana Ave Kenner LA 70065-4605 Ph: (504) 575-3712 | Tioga Jr High Sbhc 1150 Tioga Rd Ball LA 71405-3978 Ph: (866) 530-6111 |
| NPI Number | 1609595818 |
|---|---|
| Provider Enumeration Date | 08/23/2022 |
| Last Update Date | 08/29/2022 |
| Certification Date | 08/29/2022 |
| Medicare PECOS PAC ID | 3678484276 |
|---|---|
| Medicare Enrollment ID | O20230815003628 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609595818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
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