NPIMap

Organization Active NPI

Innis Community Health Center, Inc

Doing business as Livonia Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Livonia, LA
National Provider Identifier
1003910167
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
INNIS COMMUNITY HEALTH CENTER, INC
Doing business as
Livonia Community Health Center
Practice address
8387 Newfield Dr Ste B
Livonia, LA 70755-3605
Phone
(225) 412-0202
Fax
(225) 412-0366
NPI assigned
Sep 11, 2006
Last updated
Sep 28, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
INNIS COMMUNITY HEALTH CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Authorized official

Name
Cindy Griffin Peavy
Title
Executive Director
Phone
(225) 618-7161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

8387 Newfield Dr Ste B
Livonia, LA 70755-3605

Mailing address

112 Telly St
New Roads, LA 70760-2521
Phone (225) 618-5015

Other names 2

  • Livonia Community Health Center Doing business as
  • Arbor Family Health Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050825000691 LA Part B Supplier - Clinic/Group Practice 9931130358 Receives reassigned benefits from 27 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Roads, LA; Maringouin, LA; Livonia, LA; Batchelor, LA
O20051122000008 LA Part A Provider - Federally Qualified Health Center (FQHC) 9931130358 Practice locations: Livonia, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003910167. Details of each certification follow.

Federally qualified health center certification: CCN 191845

Legal name
INNIS COMMUNITY HEALTH CENTER, INC
Doing business as
LIVONIA COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 17, 2006
Last certification
Jan 17, 2006
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 2001 in LA
Enrollment address
8387 Newfield Dr
Livonia, LA 70755-3605
Related CCNs
191832

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

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
19D1046926Livonia Community Health Center8387 Newfield Drive, Suite B, Livonia, LA 70755Certificate of waiverOct 20, 2027

National Provider Directory

National Provider Directory
Part of
Livonia Comm Health Ctr

Locations

8387 Newfield Dr
Livonia, LA 70755
Phone (225) 412-0202

8387 Newfield Dr
Ste B
Livonia, LA 70755
Phone (225) 412-0202

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
John Grezaffi Individual Corporate DirectorBoard of Director Member Jun 1, 2001
Jeanine Thibodeaux Individual Corporate DirectorBoard of Director Member Jan 1, 2011
Beulah Epps Individual Corporate DirectorBoard of Director Member Jun 1, 2001
Irma Smith Individual Corporate DirectorBoard of Director Member Jan 1, 2010
Cindy G Peavy Individual Corporate OfficerCeo Jul 1, 2012
W-2 Managing EmployeeCeo Jul 1, 2012
Garrett Lejeune Individual Corporate DirectorBoard of Director Member Jul 1, 2011
Frank Foti Individual Corporate DirectorBoard of Director Member Jan 1, 2008
Chad Olinde Individual Corporate DirectorBoard of Director Member Jun 1, 2001
Reginald Franklin Individual Corporate DirectorBoard of Director Member Jan 1, 2009

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1003910167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 TELLY ST",
            "city": "NEW ROADS",
            "state": "LA",
            "postal_code": "707602521",
            "telephone_number": "225-618-5015",
            "fax_number": "225-442-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8387 NEWFIELD DR STE B",
            "city": "LIVONIA",
            "state": "LA",
            "postal_code": "707553605",
            "telephone_number": "225-412-0202",
            "fax_number": "225-412-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNIS COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INNIS COMMUNITY HEALTH CENTER, INC",
        "enumeration_date": "2006-09-11",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "PEAVY",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "GRIFFIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "225-618-7161"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Livonia Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Livonia Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arbor Family Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Livonia, LA

Sources for this page

Verify at the official NPI Registry.