Organization
MARILLAC COMMUNITY HEALTH CENTERS
Active
Other names
DePaul Community Health Centers-St. Theresa Academy
Organization subpart
No
Provider details
NPI number
Authorized official
TANYELLE OATIS-GASKEW (LEAD CREDENTIALING SPECIALIST)
(504) 212-9546
Entity
Organization
Contact information
Practice address
6421 W METAIRIE AVE, METAIRIE, LA 70003-4327
(504) 513-4400
Mailing address
3201 S CARROLLTON AVE, NEW ORLEANS, LA 70118-4307
(504) 212-9548
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/22/2022
Last updated
03/29/2023
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