Organization
NORTHWEST LOUISIANA FAMILY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SALLIE LEE BETHEA CFNP (OWNER)
(318) 377-0587
Entity
Organization
Contact information
Practice address
2 MEDICAL PLAZA PL, MINDEN, LA 71055-3330
(318) 377-0587
Mailing address
2 MEDICAL PLAZA PL, MINDEN, LA 71055-3330
(318) 377-0587
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
APO 03674
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1442429
—
LA
Enumeration date
01/04/2007
Last updated
08/22/2020
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