Provider Demographics
NPI:1275566986
Name:CENLA RURAL HEALTH CENTERS, LLC
Entity Type:Organization
Organization Name:CENLA RURAL HEALTH CENTERS, LLC
Other - Org Name:CENLA RURAL HEALTH CENTERS- COLFAX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PILAND
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:318-627-3700
Mailing Address - Street 1:220 ADAMS PATH
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-7903
Mailing Address - Country:US
Mailing Address - Phone:318-308-9950
Mailing Address - Fax:
Practice Address - Street 1:340 WEBB SMITH DR
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:LA
Practice Address - Zip Code:71417-1910
Practice Address - Country:US
Practice Address - Phone:318-627-3700
Practice Address - Fax:318-627-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1881716Medicaid
LA193867Medicare ID - Type Unspecified