MARTIN LUTHER KING HEALTH CENTER (NPI# 1265675029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265675029 |
Entity Type | Organization |
Organization Name | MARTIN LUTHER KING HEALTH CENTER |
Practice Address |
1233 Sprague St. Shreveport LA 71101 |
Practice Telephone | 3182272912 |
Practice Fax Number | 3182278105 |
Mailing Telephone | 3182272912 |
Mailing Fax Number | 3182278105 |
Enumeration Date | 2009-04-09 |
Last Update Date | 2009-04-09 |
Authorized Official Name | MS. JANET M MENTESANE (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 3182272912 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 333600000X | Pharmacy | 2441-CH | LA | Suppliers |
Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MARTIN LUTHER KING HEALTH CENTER INC | 865 Olive St, Shreveport, LA 71104-2136 |
Street Address |
1233 SPRAGUE ST. |
City | SHREVEPORT |
State | LA |
Zip Code | 71101 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
Find all providers in zip 71101 |
Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104432970 | Genetics Collection LLC | Clinic/Center | 214 W 70th St Ste 205, Shreveport, LA 71106-3756 | 2020-09-17 |
1992219836 | Gallego Health | Clinic/Center | 115 Hallette Dr, Shreveport, LA 71115-2959 | 2017-11-30 |
1265772586 | Walter Asseff | Clinic/Center | 2014 Beth Ln, Shreveport, LA 71118-2708 | 2013-02-23 |
1861671869 | Mid-city Family Clinic, LLC | Clinic/Center | 838 Margaret Pl, Shreveport, LA 71101-4509 | 2007-10-26 |
1447360524 | Ross H Dies Dds and J Cody Cowen Dds A Dental LLC | Clinic/Center | 910 Bert Kouns Industrial Loop, Shreveport, LA 71118 | 2006-08-30 |
1679594782 | Premier Care and Learning Center, Inc | Clinic/Center | 2110 Hollywood Ave, Shreveport, LA 71108-3922 | 2006-07-22 |
1932181054 | The Arthritis & Rheumatology Clinic, A Medical Corporation | Clinic/Center | 740 Jordan St, Shreveport, LA 71101-4616 | 2005-11-15 |
1285635540 | Louisiana State University Health Sciences Center Viral Disease Clini | Clinic/Center | 6670 Saint Vincent Ave, Shreveport, LA 71106-2638 | 2005-08-09 |
1871083162 | The Healing Clinic, LLC | Clinic/Center | 745 Olive St Ste 109, Shreveport, LA 71104-2250 | 2018-05-14 |
1427490937 | Bombinamd LLC | Clinic/Center | 4140 Hollywood Ave, Suite B-2, Shreveport, LA 71109-7818 | 2013-07-25 |
Find all providers in SHREVEPORT |
City | SHREVEPORT |
Zip Code | 71101 |
Please comment or provide details below to improve the information on MARTIN LUTHER KING HEALTH CENTER.
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.