Provider Demographics
NPI:1477143774
Name:CLHG-DEQUINCY LLC
Entity type:Organization
Organization Name:CLHG-DEQUINCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR OF CLINIC OPERATI
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HIPPLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-315-7093
Mailing Address - Street 1:110 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DEQUINCY
Mailing Address - State:LA
Mailing Address - Zip Code:70633-3508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 W 4TH ST
Practice Address - Street 2:
Practice Address - City:DEQUINCY
Practice Address - State:LA
Practice Address - Zip Code:70633-3301
Practice Address - Country:US
Practice Address - Phone:337-786-6161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty