Organization Name: | INNIS COMMUNITY HEALTH CENTER, INC |
NPI Number: | 1578986006 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CINDY PEAVY (EXEUTIVE DIRECTOR) |
Mailing Address: | 6450 Louisiana Highway 1 Batchelor |
State: | LA US |
Postal Code: | 70715 |
Phone Number: | 2254923775 |
Fax Number: | |
NPI Enumeration Date: | 02/04/2014 |
NPI Last Update Date: | 07/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |