NPIMap

Organization Active NPI

Teche Action Board Inc

Doing business as Teche Health @ Franklin

  • Federally Qualified Health Center (FQHC)
  • Franklin, LA
National Provider Identifier
1174579262
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
04402470N Issued in LA
Legal business name
TECHE ACTION BOARD INC
Doing business as
Teche Health @ Franklin
Practice address
1115 Weber St
Franklin, LA 70538-4124
Phone
(337) 828-2550
Fax
(337) 355-2335
NPI assigned
May 26, 2006
Last updated
Aug 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Gary M Wiltz, M.D.NPI 1477596351
Title
Chief Executive Officer
Phone
(337) 828-2550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 04402470N LA Primary

Addresses

Primary practice location

1115 Weber St
Franklin, LA 70538-4124

Mailing address

1115 Weber St
Franklin, LA 70538-4124
Phone (337) 828-2550

Other names 1

  • Teche Health @ Franklin Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041109000792 LA Part B Supplier - Clinic/Group Practice 0648163980 Receives reassigned benefits from 39 practitioners
17 other NPIs on this enrollment
Practice locations: La Place, LA; Vacherie, LA; Thibodaux, LA; Reserve, LA; Pierre Part, LA; Morgan City, LA; Houma, LA; Gramercy, LA…
O20101122001355 LA Part A Provider - Federally Qualified Health Center (FQHC) 0648163980 Practice locations: Franklin, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174579262. Details of each certification follow.

Federally qualified health center certification: CCN 191801

Legal name
TECHE ACTION BOARD INC
Doing business as
TECHE HEALTH @ FRANKLIN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 14, 1974 in LA
Enrollment address
1115 Weber St
Franklin, LA 70538-4124

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

Other NPIs with the same Medicare PAC ID 11

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

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory

Locations

18333 Highway 182
Baldwin, LA 70514
Phone (337) 924-7990

149 E 3rd St
Edgard, LA 70049

1 Giordano Ln
Reserve, LA 70084
Phone (985) 536-6492

1713 Ridgefield Rd
Thibodaux, LA 70301

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Willie Rack Individual Corporate DirectorBoard Member Nov 3, 2014
Howard Castay Individual Corporate DirectorBoard Member Sep 24, 2010
Berryl Broussard Individual W-2 Managing EmployeeChief Legal Officer May 3, 2021
Thomas Dardar Individual Corporate Director Sep 24, 2010
Barbara Hills Individual Corporate OfficerSecretary Dec 5, 2011
Eugene Dial Individual Corporate DirectorBoard Member Jan 3, 2022
Leroy Willis Individual Corporate OfficerPresident Dec 5, 2011
Edna Lyons Individual Corporate Director Sep 24, 2010
Darrell Jupiter Individual Corporate Director Sep 24, 2010
Denise Pitts Individual Corporate Director Sep 24, 2010
Nikina Vilcan Individual W-2 Managing EmployeeCfo Aug 3, 2020
Rose Dorsey Individual Corporate OfficerTresurer Dec 5, 2011
Gary M Wiltz Individual Corporate OfficerCeo Sep 24, 2010
W-2 Managing Employee Sep 24, 2010
Donnie Frizzell Individual Corporate Director Sep 24, 2010
Athan J Olivier Individual W-2 Managing EmployeeCoo Apr 22, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1174579262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 WEBER ST",
            "city": "FRANKLIN",
            "state": "LA",
            "postal_code": "705384124",
            "telephone_number": "337-828-2550",
            "fax_number": "337-355-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 WEBER ST",
            "city": "FRANKLIN",
            "state": "LA",
            "postal_code": "705384124",
            "telephone_number": "337-828-2550",
            "fax_number": "337-355-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TECHE ACTION BOARD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "WILTZ",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "337-828-2550",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "LA",
            "license": "04402470N",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teche Health @ Franklin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Franklin, LA

Sources for this page

Verify at the official NPI Registry.