Organization
CAPITOL CITY FAMILY HEALTH CENTER, INCORPORATED
Active
Other names
CareSouth Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW VALLIERE (CEO)
(225) 650-2026
Entity
Organization
Contact information
Practice address
20474 OLD SCENIC HWY, ZACHARY, LA 70791-7365
(225) 478-1174
Mailing address
PO BOX 66156, BATON ROUGE, LA 70896-6156
(225) 650-2000
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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