Organization
DAVID RAINES COMMUNITY HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE C WHITE (CEO)
(318) 425-2252
Entity
Organization
Contact information
Practice address
128 HOMER RD, MINDEN, LA 71055-2732
(318) 377-1545
(318) 377-1504
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
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1941638
—
LA
Enumeration date
06/27/2005
Last updated
02/13/2024
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