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Organization

TECHE ACTION BOARD, INC.

Active
Parent organization
TECHE ACTION BOARD, INC.
Other names
Teche Action Clinic @ Acadian Elementary School
Organization subpart
Yes

Provider details

NPI number
Legal business name
TECHE ACTION BOARD, INC.
Authorized official
DR. GARY M WILTZ MD (CEO)
(337) 828-2550
Entity
Organization

Contact information

Practice address
1020 SAADI ST, HOUMA, LA 70363-6748
(985) 876-8465
(985) 876-8466
Mailing address
1115 WEBER ST, FRANKLIN, LA 70538-4124
(337) 828-2550
(337) 355-2333

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5B803
MEDICARE PART B
LA
Enumeration date
12/14/2022
Last updated
07/12/2023
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