Organization
MULTIPRACTICE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA SHARPLESS (CEO)
(985) 878-0066
Entity
Organization
Contact information
Practice address
281 W 4TH ST, INDEPENDENCE, LA 70443-2386
(985) 878-0066
(985) 878-0969
Mailing address
PO BOX 130, INDEPENDENCE, LA 70443-0130
(985) 878-0066
(985) 878-0969
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1448109
—
LA
01
—
191849
MEDICARE NGS
LA
Enumeration date
11/02/2005
Last updated
10/13/2011
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