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Organization
CHRISTUS HEALTH CENTRAL LOUISIANA
Active
Organization
CHRISTUS HEALTH CENTRAL LOUISIANA
Active
Other names
Grant SBHC
Organization subpart
No
Provider details
NPI number
Authorized official
MONTE WILSON (CEO)
(337) 470-2100
Entity
Organization
Contact information
Practice address
17763 HIGHWAY 167, DRY PRONG, LA 71423-9205
(318) 899-5276
(318) 899-5932
Mailing address
3330 MASONIC DR, ALEXANDRIA, LA 71301-3841
(318) 483-4031
(318) 483-4044
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
234
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1446971
—
LA
Enumeration date
03/29/2007
Last updated
10/19/2022
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