Organization
DAVID RAINES COMMUNITY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE WHITE III (CEO)
(318) 227-3350
Entity
Organization
Contact information
Practice address
3021 W 70TH ST, SHREVEPORT, LA 71108-4603
(318) 227-3350
Mailing address
3041 DR MARTIN LUTHER KING DR, SHREVEPORT, LA 71107-4705
(318) 227-3350
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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