Organization
CHRISTUS HEALTH CENTRAL LOUISIANA
Active
Parent organization
CHRISTUS HEALTH
Other names
Provencal SBHC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHRISTUS HEALTH
Authorized official
MONTE WILSON (CEO)
(337) 470-2100
Entity
Organization
Contact information
Practice address
132 CHERRY ST, PROVENCAL, LA 71468
(318) 472-8660
(318) 472-8661
Mailing address
3330 MASONIC DR, ALEXANDRIA, LA 71301-3841
(318) 483-4031
(318) 483-4044
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
234
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1808814
—
LA
Enumeration date
07/28/2008
Last updated
10/19/2022
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