| Organization Name: | DAVID RAINES COMMUNITY HEALTH CENTER, INC |
| NPI Number: | 1912903964 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIE C WHITE (CEO) |
| Mailing Address: | 1953 Main St Haynesville |
| State: | LA US |
| Postal Code: | 710384907 |
| Phone Number: | 3186241995 |
| Fax Number: | 3186251985 |
| NPI Enumeration Date: | 06/23/2005 |
| NPI Last Update Date: | 02/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| 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: | |