Provider Demographics
NPI:1366626574
Name:WEST JEFFERSON SCHOOL BASED HEALTH CENTER
Entity Type:Organization
Organization Name:WEST JEFFERSON SCHOOL BASED HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DATA COORDINATOR
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:504-349-8996
Mailing Address - Street 1:822 S CLEARVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-3401
Mailing Address - Country:US
Mailing Address - Phone:504-348-9899
Mailing Address - Fax:504-349-8985
Practice Address - Street 1:2200 8TH ST
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-4006
Practice Address - Country:US
Practice Address - Phone:504-367-4407
Practice Address - Fax:504-367-4327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service