Organization
JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHONDRA G WILLIAMS APRN,PHD (CEO)
(504) 762-8931
Entity
Organization
Contact information
Practice address
1855 AMES BLVD, SUITE B, MARRERO, LA 70072-3429
(504) 437-8528
Mailing address
1855 AMES BLVD, SUITE B, MARRERO, LA 70072-3429
(504) 437-8528
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1854441
—
LA
Enumeration date
04/03/2014
Last updated
04/03/2014
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