NPIMap

Organization Active NPI

CLHG-Acadian LLC

Doing business as Louisiana Family Practice

  • Rural Health Clinic/Center
  • Eunice, LA
National Provider Identifier
1003467440
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CLHG-ACADIAN LLC
Doing business as
Louisiana Family Practice
Practice address
151 Hill St Ste 102
Eunice, LA 70535-5845
Phone
(337) 457-8040
Fax
(337) 457-3432
NPI assigned
Sep 26, 2019
Last updated
Sep 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kevin F Frank
Title
Ceo
Phone
(337) 580-7504

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

151 Hill St Ste 102
Eunice, LA 70535-5845

Mailing address

151 Hill St Ste 102
Eunice, LA 70535-5845
Phone (337) 457-8040

Other names 1

  • Louisiana Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200924002230 LA Part A Provider - Rural Health Clinic 0840521209 Practice locations: Eunice, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003467440. Details of each certification follow.

Rural health clinic certification: CCN 198539

Legal name
CLHG-ACADIAN LLC
Doing business as
LOUISIANA FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 18, 2021
Last certification
Mar 18, 2021
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Aug 5, 2016 in LA
Enrollment address
151 Hill St
Ste 102
Eunice, LA 70535-5845
Related CCNs
190318

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2193579Louisiana Family Practice151 Hill Street, Eunice, LA 70535Certificate of waiverSep 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
CLHG-Oakdale LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

151 Hill St
#102
Eunice, LA 70535

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Donald Cameron Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2020 16%
Corporate DirectorBoard Member Sep 1, 2020
Operational/Managerial ControlOwner Board Member Sep 1, 2020
Rock Bordelon Individual 5% Or Greater Direct Ownership Interest Sep 1, 2020 80%
Corporate DirectorBoard Member Sep 1, 2020
Operational/Managerial ControlOwner Board Member Sep 1, 2020
Allegiance Health Management Inc Organization, Shreveport, LA Corporation Operational/Managerial Control Sep 1, 2020
David Ingram Individual Corporate DirectorCeo Aug 1, 2024
W-2 Managing Employee Aug 1, 2024 100%
Cameron Investments LLC Organization, Shreveport, LA LLC 5% Or Greater Direct Ownership Interest Sep 1, 2020 16%

Facilities with the same owner 53

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 53

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1003467440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 HILL ST STE 102",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705355845",
            "telephone_number": "337-457-8040",
            "fax_number": "337-457-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 HILL ST STE 102",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705355845",
            "telephone_number": "337-457-8040",
            "fax_number": "337-457-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLHG-ACADIAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "FRANK",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-580-7504"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louisiana Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Louisiana Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eunice, LA

Sources for this page

Verify at the official NPI Registry.