| Innis Community Health Center, Inc | |
|
1653 Valverda Rd Maringouin LA 70757-5118 | |
| (225) 492-3775 | |
| Not Available |
| Full Name | Innis Community Health Center, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1653 Valverda Rd, Maringouin, 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 1653 Valverda Rd Maringouin LA 70757-5118 Ph: (225) 492-3775 |
| NPI Number | 1164897542 |
|---|---|
| Provider Enumeration Date | 12/10/2015 |
| Last Update Date | 11/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164897542 | NPI | - | NPPES |
| 2408054 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Maringouin Medical Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 77695 Wagley Rd, Maringouin, LA 70757 Phone: 225-625-2313 Fax: 225-625-2424 | |
Innis Community Health Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 77575 Landry Drive, Maringouin, LA 70757 Phone: 225-625-2105 Fax: 225-625-2109 |