Organization
DAVID RAINES COMMUNITY HEALTH CENTER INC
Active
Parent organization
DAVID RAINES COMMUNITY HEALTH CENTER INC
Other names
David Raines Community Health Center - Mobile Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVID RAINES COMMUNITY HEALTH CENTER INC
Authorized official
MR. WILLIE C WHITE III (CHIEF EXECUTIVE OFFICER)
(318) 227-3350
Entity
Organization
Contact information
Practice address
1625 DAVID RAINES RD, SHREVEPORT, LA 71107-5899
(318) 425-2252
(318) 425-2367
Mailing address
3041 DR MARTIN LUTHER KING DR, SHREVEPORT, LA 71107-4705
(318) 227-3350
(318) 222-2979
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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