INNIS COMMUNITY HEALTH CENTER, INC (NPI# 1013496561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013496561 |
Entity Type | Organization |
Organization Name | INNIS COMMUNITY HEALTH CENTER, INC |
Other Organization Name | BRUSLY SCHOOL BASED HEALTH |
Practice Address |
630 North Vaughn Drive Brusly LA 70719 |
Mailing Address |
6450 Louisiana Highway 1 Batchelor LA 70715 |
Practice Telephone | 2254923775 |
Mailing Telephone | 2254923775 |
Mailing Fax Number | 2254923782 |
Enumeration Date | 2018-08-07 |
Last Update Date | 2018-08-07 |
Authorized Official Name | CINDY GRIFFIN PEAVY (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 2254923775 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Brusly School Based Health | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689138018 | Innis Community Health Center, Inc | Clinic/Center | 8434 Pointe Coupee Road, New Roads, LA 70760 | 2019-01-30 |
1053841072 | Innis Community Health Center, Inc | Clinic/Center | 230 Roberts Dr Ste H, New Roads, LA 70760-2661 | 2017-06-13 |
1992170385 | Innis Community Health Center, Inc | Clinic/Center | 1100 New Roads St, New Roads, LA 70760-2300 | 2015-12-10 |
1184099574 | Innis Community Health Center, Inc | Clinic/Center | 3118 La Highway 78, Livonia, LA 70755 | 2015-12-10 |
1417322892 | Innis Community Health Center, Inc | Clinic/Center | 4739 La Highway 419, Batchelor, LA 70715-3472 | 2015-12-10 |
1780059162 | Innis Community Health Center, Inc | Clinic/Center | 13258 La Highway 416, Rougon, LA 70773 | 2015-12-10 |
1538538863 | Innis Community Health Center, Inc | Clinic/Center | 77575 Landry Drive, Maringouin, LA 70757-3028 | 2015-09-16 |
1578986006 | Innis Community Health Center, Inc | Clinic/Center | 8737 Newfield Drive, Livonia, LA 70755 | 2014-02-04 |
1821287202 | Innis Community Health Center, Inc | Clinic/Center | 8366 Pointe Coupee Rd, Morganza, LA 70759-3320 | 2007-10-22 |
1003910167 | Innis Community Health Center, Inc | Clinic/Center | 8387 Newfield Dr, Livonia, LA 70755-3605 | 2006-09-11 |
Street Address |
630 NORTH VAUGHN DRIVE |
City | BRUSLY |
State | LA |
Zip Code | 70719 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124673827 | Lauren Jarreau | Social Worker | 630 Vaughn Drive, Brusly, LA 70719 | 2019-08-08 |
1831355155 | Dynamic Therapy, LLC | Physical Therapist | 309 S Vaughn Drive, Suite F, Brusly, LA 70719 | 2008-08-06 |
1295802627 | Daniel Pharmacy LLC | Pharmacy | 710 East Main St, Brusly, LA 70719 | 2006-11-29 |
1740360429 | Donald H. De Latin | Dentist | 161 Riverside Village Blvd, Brusly, LA 70719 | 2006-10-16 |
1932292190 | Pcpt of West Baton Rouge, Inc | Physical Therapist | 402 North Vaughn, Brusly, LA 70719 | 2006-10-02 |
1538110242 | Dynamic Therapy, LLC | Occupational Therapist | 309 S. Vaughn Drive, Suite F, Brusly, LA 70719 | 2006-05-15 |
1396217337 | Tonnisha Ellis | Case Manager/Care Coordinator | 2699 Orleans Quarters Dr, Brusly, LA 70719-2190 | 2018-12-31 |
1659713709 | Brightside Day Habilitation, Inc | Day Training, Developmentally Disabled Services | 557 E Main St Ste A, Brusly, LA 70719-2210 | 2013-07-17 |
1528558020 | Brightside Day Habilitation, Inc | Day Training/Habilitation Specialist | 557 E Main St, Brusly, LA 70719-2210 | 2018-05-10 |
1982003398 | Brightside Day Habilitation | Day Training, Developmentally Disabled Services | 557 E Main St, A, Brusly, LA 70719-2210 | 2014-08-21 |
Find all providers in zip 70719 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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1013522879 | Marillac Community Health Centers | Clinic/Center | 1423 Saint Philip St, New Orleans, LA 70116-2933 | 2020-09-09 |
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Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.