Teche Action Clinic @ Reserve

LBN: Teche Action Board Inc
Teche Action Clinic @ Reserve is an health care organization with primary practice located at 473 Central Ave , Reserve LA 70084-5509. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Teche Action Board Inc can be contacted via phone (985) 479-1315, or through Wiltz, Gary M via phone (337) 828-2550.

Contact Information

Primary practice address
473 Central Ave Reserve LA 70084-5509
Phone: (985) 479-1315
Fax: (985) 479-1328
Website:
Map and Directions
Authorized official contact:
Name: Wiltz, Gary M Doctor of Medicine (MD)
Phone: (337) 828-2550

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X Louisiana

Profile Details

NPI number 1386880433
LBN Legal business name Teche Action Board Inc
DBA Doing business as Teche Action Clinic @ Reserve
Authorized official Wiltz, Gary M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 19th, 2008
Last updated Jul 12th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386880433 NPPES
Louisiana MEDICAID 1803782
Louisiana Other 5B803

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