| Organization Name: | EAST JEFFERSON COMMUNITY HEALTH CENTER |
| NPI Number: | 1174664510 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICIA ANN BOWMAN (CO-CHAIR) |
| Mailing Address: | 11312 Jefferson Hwy River Ridge |
| State: | LA US |
| Postal Code: | 701231709 |
| Phone Number: | 5044640032 |
| Fax Number: | 5044663440 |
| NPI Enumeration Date: | 02/09/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | 80-001271 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |