ST GABRIEL HEALTH CLINIC , INC (NPI# 1760858302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760858302 |
| Entity Type | Organization |
| Organization Name | ST GABRIEL HEALTH CLINIC , INC |
| Other Organization Name | BATON ROUGE CHARTER ACADEMY AT MID CITY SATELLITE CLINIC |
| Practice Address |
1900 Lobdell Blvd Baton Rouge LA 70806-1725 |
| Mailing Address |
Po Box 209 Saint Gabriel LA 70776-0209 |
| Practice Telephone | 2258103125 |
| Practice Fax Number | 2256429696 |
| Mailing Telephone | 2256429676 |
| Mailing Fax Number | 2256429696 |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-18 |
| 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 |
|---|---|
| Baton Rouge Charter Academy at Mid City Satellite Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| Street Address |
1900 LOBDELL BLVD |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70806-1725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437663481 | Geo Prep At Mid-city Inc. | Local Education Agency (LEA) | 1900 Lobdell Blvd, Baton Rouge, LA 70806-1725 | 2017-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467064790 | Horizon Network LLC | Community/Behavioral Health | 921 Lobdell Blvd Suite D, Baton Rouge, LA 70806 | 2020-08-18 |
| 1093324220 | Raghu Rudraraju | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard Baton Rouge General Mid City Medi, Suite 130, Baton Rouge, LA 70806 | 2020-07-23 |
| 1619595584 | Brown's Pharmacy, LLC | Pharmacy | 1718 North Foster Drive, Suite B, Baton Rouge, LA 70806 | 2020-07-08 |
| 1497374847 | Yara Mouawad | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Suite 130, Baton Rouge, LA 70806 | 2020-04-15 |
| 1396364527 | Sai Samyuktha Bandaru | Student in an Organized Health Care Education/Training Program | Brg Mid City Medicine Clinic, 3401 North Boulevard, Sui, Baton Rouge, LA 70806 | 2020-04-08 |
| 1588299812 | Iraneeka S Gustave | Peer Specialist | Kelwood Ave, 8326 Kelwood Ave, Baton Rouge, LA 70806 | 2020-03-06 |
| 1518522192 | Silpita Katragadda | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Brg Midcity Medicine Clinic, Suite 130, Baton Rouge, LA 70806 | 2019-05-08 |
| 1437713997 | Dental Solutions, LLC | Dentist | 5629 Government St, Baton Rouge, LA 70806 | 2019-04-30 |
| 1699249516 | Shea Lafountain | Counselor | 624 Connell's Park Lane, Baton Rouge, LA 70806 | 2019-01-14 |
| 1033682802 | Genesis Specialty Groups, LLC | Clinic/Center | 778 Chevelle Drive, Baton Rouge, LA 70806 | 2019-01-04 |
| Find all providers in zip 70806 | ||||
| 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 |
| 1710354022 | St Gabriel Health Clinic, Inc | Clinic/Center | 9211 Parkway Dr, Baton Rouge, LA 70810 | 2015-08-24 |
| 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 | 70806 |
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.