Collective Rural Healthcare System LLC
Clinic/Center, Rural Health in Elizabeth, LA. Organization (NPI-2).
NPI number1841908761
StatusActive
Last updated in NPPESNov 11, 2022
Details
- NPI
- 1841908761
- Entity type
- Organization (NPI-2)
- Legal business name
- Collective Rural Healthcare System LLC
- Organization subpart
- No
- Enumeration date
- Nov 9, 2022
- Certification date
- Nov 11, 2022
- Last updated
- Nov 11, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | – | – | Yes |
Other names
- Elizabeth Family Clinic (Doing Business As)
Practice location
4855 Highway 10 WestSuite C
Elizabeth, LA 70638
Phone 318-634-5600 · Fax 318-634-5602
Mailing address
912 Bryan StCottonport, LA 71327-4288
Phone 888-995-0591 · Fax 318-581-9067
Authorized official
Alec Donovan Jeansonne
Ceo
3188802144
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