# CHRISTUS HEALTH CENTRAL LOUISIANA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Glenmora SBHC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376664706
- **Authorized official:** MONTE WILSON (CEO)
- **Authorized official phone:** (337) 470-2100

## Contact information

- **Practice address:** 1414 7TH AVENUE, GLENMORA, LA 71433
- **Practice address phone:** (318) 748-8974
- **Practice address fax:** (318) 748-8986
- **Mailing address:** 3330 MASONIC DR, ALEXANDRIA, LA 71301-3841
- **Mailing address phone:** (318) 483-4031
- **Mailing address fax:** (318) 483-4044

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | 234 | LA | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 10/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1446955 | — | LA |