ST GABRIEL HEALTH CLINIC, INC (NPI# 1710354022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710354022 |
| Entity Type | Organization |
| Organization Name | ST GABRIEL HEALTH CLINIC, INC |
| Other Organization Name | SOUTH BATON ROUGE CHARTER ACADEMY SATELLITE CLINIC |
| Practice Address |
9211 Parkway Dr Baton Rouge LA 70810 |
| Mailing Address |
P O Box 209 St Gabriel LA 70776 |
| Practice Telephone | 2253497489 |
| Practice Fax Number | 2256469696 |
| Mailing Telephone | 2256429676 |
| Mailing Fax Number | 2256429696 |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |
| Authorized Official Name | MARILYN B ANTWINE (COO) |
| Authorized Official Telephone | 2256429676 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST GABRIEL HEALTH CLINIC, INC |
| 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 |
|---|---|
| South Baton Rouge Charter Academy Satellite Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356718662 | St Gabriel Health Clinic, Inc | Clinic/Center | 24360 Enterprise Boulevard, Plaquemine, LA 70764 | 2015-08-24 |
| Street Address |
9211 PARKWAY DR |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639734973 | Baton Rouge Clinic, A Medical Corporation | Podiatrist | 8160 Ymca Blvd, Suite C, Baton Rouge, LA 70810 | 2019-05-02 |
| 1699278135 | Taylor Denise Debourg | Specialist/Technologist | 8921 Boone Drive, Baton Rouge, LA 70810 | 2018-03-12 |
| 1528583945 | Baton Rouge Perio, L.L.C. | Dentist | 10723 N. Oak Hills Parkway, Bldg. B, Baton Rouge, LA 70810 | 2017-08-07 |
| 1902334931 | Reginald Shaffer | Counselor | 13621 Kenner Ave Apt C, Baton Rouge, LA 70810 | 2017-06-03 |
| 1770010381 | Keona Julien | Case Manager/Care Coordinator | 9270 Siegen Ln Suite 101, Baton Rouge, LA 70810 | 2017-05-12 |
| 1205372893 | Grand Canyon Mobile Dentistry | Dentist | 8480 Bluebonnet Blvd Ste E, Baton Rouge, LA 70810 | 2017-01-06 |
| 1215395173 | Kimberly Booker | Counselor | 9371 Bimini Dr, Baton Rouge, LA 70810 | 2016-02-08 |
| 1942682430 | Jasmine Alexander | Counselor | 9270 Siegen Ln Bldg 101, Baton Rouge, LA 70810 | 2015-06-22 |
| 1073991535 | James Michael Robinson | Family Medicine | 12525 Perkins Rd Ste A, Baton Rouge, LA 70810 | 2015-05-15 |
| 1699185579 | Parker Jones | Psychiatry & Neurology | 3342 Rue D' Orleans Dr., Baton Rouge, LA 70810 | 2014-05-01 |
| Find all providers in zip 70810 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093371494 | St. Gabriel Health Clinic, Inc | Clinic/Center | 3605 Ontario St, Baton Rouge, LA 70805-5840 | 2019-05-13 |
| 1447816954 | St. Gabriel Health Clinic, Inc | Clinic/Center | 4705 Lanier Dr, Baton Rouge, LA 70812-4020 | 2019-05-10 |
| 1013405646 | St Gabriel Health Clinic, Inc | Clinic/Center | 7800 Innovation Dr, Baton Rouge, LA 70820 | 2018-04-30 |
| 1710475496 | St Gabriel Health Clinic, Inc | Clinic/Center | 1500 N Airway Dr, Baton Rouge, LA 70815-8060 | 2018-04-27 |
| 1164949251 | St Gabriel Health Clinic, Inc | Clinic/Center | 6180 Winbourne Ave, Baton Rouge, LA 70805-6266 | 2017-08-29 |
| 1760858302 | St Gabriel Health Clinic, Inc | Clinic/Center | 1900 Lobdell Blvd, Baton Rouge, LA 70806-1725 | 2015-08-18 |
| 1962777136 | St. Gabriel Health Clinic, Inc. | Clinic/Center | 1707 Gardere Ln Ste E, Baton Rouge, LA 70820-8144 | 2012-03-20 |
| 1255665832 | Baton Rouge Primary Care Collabora | Clinic/Center | 153 N. 17th Street, Baton Rouge, LA 70802-3813 | 2009-09-29 |
| 1457974693 | Hiv-aids Alliance for Region Two | Clinic/Center | 3905 Convention St, Baton Rouge, LA 70806-3806 | 2020-05-22 |
| 1770119588 | Hiv/aids Alliance for Region Two, Inc | Clinic/Center | 3849 North Blvd, Baton Rouge, LA 70806-3854 | 2020-03-13 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70810 |
Please comment or provide details below to improve the information on ST GABRIEL HEALTH CLINIC, INC.
| 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.