| Organization Name: | SOUTHWEST LOUISIANA PRIMARY HEALTH CARE CENTER, INC |
| NPI Number: | 1093843187 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DODIE LAMOTT (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 8762 Highway 182 Opelousas |
| State: | LA US |
| Postal Code: | 705705603 |
| Phone Number: | 3379422005 |
| Fax Number: | 3379428644 |
| NPI Enumeration Date: | 03/01/2007 |
| NPI Last Update Date: | 08/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |