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Organization
CLINICS OF THE SOUTHEAST LLC
Active
Organization
CLINICS OF THE SOUTHEAST LLC
Active
Parent organization
CLINIC OF THE SOUTHEAST LLC
Other names
Bogalusa Family Medicine & Behavioral Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLINIC OF THE SOUTHEAST LLC
Authorized official
ANTHONY JUDE PALAZZO (CEO)
(985) 735-7707
Entity
Organization
Contact information
Practice address
219 S BORDER DR, BOGALUSA, LA 70427-3671
(985) 732-1568
Mailing address
PO BOX 370, BOGALUSA, LA 70429-0370
(985) 732-1568
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
NULL
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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