Provider Demographics
NPI:1467792713
Name:JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC
Entity Type:Organization
Organization Name:JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC
Other - Org Name:RFK - LAFITTE MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JOELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:JESSIE SKINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-437-8523
Mailing Address - Street 1:5140 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LAFITTE
Mailing Address - State:LA
Mailing Address - Zip Code:70067-5256
Mailing Address - Country:US
Mailing Address - Phone:504-689-3300
Mailing Address - Fax:504-689-8223
Practice Address - Street 1:5140 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LAFITTE
Practice Address - State:LA
Practice Address - Zip Code:70067-5256
Practice Address - Country:US
Practice Address - Phone:504-689-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)