Provider Demographics
NPI:1740601418
Name:WINN COMMUNITY HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:WINN COMMUNITY HEALTH CENTER, INC.
Other - Org Name:GRANT COMMUNITY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEANO
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-648-0375
Mailing Address - Street 1:340 WEBB SMITH DR
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:LA
Mailing Address - Zip Code:71417-1910
Mailing Address - Country:US
Mailing Address - Phone:318-648-0375
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:318-648-0375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)