Organization
JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC
Active
Other names
RFK-Lafitte Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHONDRA G WILLIAMS DNP (CHIEF EXECUTIVE OFFICER)
(504) 762-8931
Entity
Organization
Contact information
Practice address
5140 CHURCH ST, LAFITTE, LA 70067-5256
(504) 689-3300
(504) 689-8223
Mailing address
PO BOX 2490, MARRERO, LA 70073-2490
(504) 437-8528
(504) 436-2224
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2337238
—
LA
Enumeration date
02/24/2014
Last updated
02/24/2014
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