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Organization
CHRISTUS HEALTH CENTRAL LOUISIANA
Active
Organization
CHRISTUS HEALTH CENTRAL LOUISIANA
Active
Other names
CHRISTUS Coushatta Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MONTE WILSON (CEO)
(337) 470-2100
Entity
Organization
Contact information
Practice address
1401 INDUSTRIAL DR, COUSHATTA, LA 71019
(318) 932-2100
(318) 932-2010
Mailing address
PO BOX 847329, DALLAS, TX 75284-7329
(800) 756-7999
(469) 282-1791
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
551RHC-1
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1880795
—
LA
Enumeration date
11/18/2005
Last updated
10/20/2022
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