Organization
PRIMARY HEALTH SERVICES CENTER
Active
Other names
PHSC Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHERINE M TONORE (CEO)
(318) 388-1250
Entity
Organization
Contact information
Practice address
2914 BETIN AVE, MONROE, LA 71201-7258
(318) 323-4450
(318) 323-4430
Mailing address
PO BOX 7495, MONROE, LA 71211-7495
(318) 388-1250
(318) 388-0948
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2177427
—
LA
Enumeration date
05/26/2011
Last updated
04/15/2021
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