Provider Demographics
NPI:1275754582
Name:JEFFERSON PARISH SCHOOL BASED HEALTH CENTER
Entity Type:Organization
Organization Name:JEFFERSON PARISH SCHOOL BASED HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:BENOIT
Authorized Official - Last Name:SCHOUEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-341-0645
Mailing Address - Street 1:8101 SIMON ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-6427
Mailing Address - Country:US
Mailing Address - Phone:504-737-5523
Mailing Address - Fax:504-737-2649
Practice Address - Street 1:300 FOURTH ST
Practice Address - Street 2:
Practice Address - City:WESTWEGO
Practice Address - State:LA
Practice Address - Zip Code:70094-4335
Practice Address - Country:US
Practice Address - Phone:504-341-0645
Practice Address - Fax:504-341-0689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1446491Medicaid