Provider Demographics
NPI:1881665164
Name:CLHG-LEESVILLE
Entity Type:Organization
Organization Name:CLHG-LEESVILLE
Other - Org Name:BYRD REGIONAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:337-526-4124
Mailing Address - Street 1:1020 W FERTITTA BLVD
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-4645
Mailing Address - Country:US
Mailing Address - Phone:318-239-9041
Mailing Address - Fax:318-239-5360
Practice Address - Street 1:1020 W FERTITTA BLVD
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-4645
Practice Address - Country:US
Practice Address - Phone:318-239-9041
Practice Address - Fax:318-239-5360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA190282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1745618Medicaid
60826OtherBCBS
066162OtherCOMMUNITY HEALTH NETWORK
199852900OtherUS DEPT OF LABOR
LA190164Medicare Oscar/Certification