Provider Demographics
NPI:1720054075
Name:TENSAS COMMUNITY HEALTH CENTER INC
Entity Type:Organization
Organization Name:TENSAS COMMUNITY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-766-1967
Mailing Address - Street 1:PO BOX 46
Mailing Address - Street 2:
Mailing Address - City:ST JOSEPH
Mailing Address - State:LA
Mailing Address - Zip Code:71366-0046
Mailing Address - Country:US
Mailing Address - Phone:318-766-1967
Mailing Address - Fax:318-766-9090
Practice Address - Street 1:1115 LEVEE ROAD
Practice Address - Street 2:
Practice Address - City:ST JOSEPH
Practice Address - State:LA
Practice Address - Zip Code:71366-0046
Practice Address - Country:US
Practice Address - Phone:318-766-1967
Practice Address - Fax:318-766-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2020-04-30
Deactivation Date:2018-08-23
Deactivation Code:
Reactivation Date:2018-12-12
Provider Licenses
StateLicense IDTaxonomies
LA261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1448664Medicaid
LA1448664Medicaid