# CLHG-LEESVILLE

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

## Provider details

- **NPI number:** 1831659333
- **Authorized official:** DONALD E. CAMERON (BOARD MEMBER)
- **Authorized official phone:** (318) 226-8202

## Contact information

- **Practice address:** 412 S PINE ST, DERIDDER, LA 70634-4840
- **Practice address phone:** (337) 462-5700
- **Practice address fax:** (337) 462-6856
- **Mailing address:** 1020 W FERTITTA BLVD, LEESVILLE, LA 71446-4645
- **Mailing address phone:** (337) 239-9401
- **Mailing address fax:** (318) 239-5360

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/21/2019
- **Last updated:** 03/16/2023