# CLHG-LEESVILLE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** West Louisiana Family Practice - Leesville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194411694
- **Authorized official:** KEVIN JAMES QUINN (CEO)
- **Authorized official phone:** (337) 239-9041

## Contact information

- **Practice address:** 1201 W FERTITTA BLVD, LEESVILLE, LA 71446-4637
- **Practice address phone:** (337) 392-9438
- **Mailing address:** 1201 W FERTITTA BLVD, LEESVILLE, LA 71446-4637

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/17/2023
- **Last updated:** 12/16/2024