Organization Name: | PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA, INC |
NPI Number: | 1770760902 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GINGER A. HUNT (CEO) |
Mailing Address: | 751 Court Street Port Allen |
State: | LA US |
Postal Code: | 707672635 |
Phone Number: | 2253891311 |
Fax Number: | 2256833411 |
NPI Enumeration Date: | 01/30/2008 |
NPI Last Update Date: | 12/22/2014 |
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: |