# ACCESS HEALTH LOUISIANA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St Charles Community Health Center, Destrehan
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326342064
- **Authorized official:** TRENTON BUSSEY (CFO)
- **Authorized official phone:** (985) 785-5800

## Contact information

- **Practice address:** 843 MILLING AVE, LULING, LA 70070-4442
- **Practice address phone:** (985) 785-5800
- **Practice address fax:** (985) 785-5811
- **Mailing address:** 843 MILLING AVE, LULING, LA 70070-4442
- **Mailing address phone:** (985) 785-5800
- **Mailing address fax:** (985) 785-5811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD04201R | LA | Yes |
| 207RC0000X | Cardiovascular Disease Physician | MD.04201R | LA | — |
| 207RN0300X | Nephrology Physician | MD.03945R | LA | — |

## Other

- **Enumeration date:** 01/10/2011
- **Last updated:** 08/06/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2156501 | — | LA |