Organization
TECHE ACTION BOARD, INC.
Active
Other names
Teche Health SBHC @ East St. John High
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY M WILTZ M.D. (CEO)
(337) 828-2550
Entity
Organization
Contact information
Practice address
1 WILDCAT DR, RESERVE, LA 70084-5800
(337) 828-2550
(337) 355-2335
Mailing address
1115 WEBER ST, FRANKLIN, LA 70538-4124
(337) 828-2550
(337) 355-2335
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2426273
—
LA
Enumeration date
05/18/2016
Last updated
08/11/2025
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