NPIMap

Organization Active NPI

Marillac Community Health Centers

Doing business as DePaul Community Health Centers-Dwight D. Eisenhower Charter School

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
National Provider Identifier
1285249185
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MARILLAC COMMUNITY HEALTH CENTERS
Doing business as
DePaul Community Health Centers-Dwight D. Eisenhower Charter School
Practice address
3700 Tall Pines Dr
New Orleans, LA 70131-8432
Phone
(504) 207-3064
Fax
(504) 282-2213
NPI assigned
Sep 9, 2020
Last updated
Nov 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Michael Griffin
Title
President/Ceo
Phone
(504) 207-3060

Specialties & licenses 1

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

Addresses

Primary practice location

3700 Tall Pines Dr
New Orleans, LA 70131-8432

Mailing address

PO Box 13038
New Orleans, LA 70185-3038
Phone (504) 207-3060

Other names 1

  • DePaul Community Health Centers-Dwight D. Eisenhower Charter School Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260311000240 LA Part A Provider - Federally Qualified Health Center (FQHC) 3678755535 Practice locations: New Orleans, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285249185. Details of each certification follow.

Federally qualified health center certification: CCN 951197

Legal name
MARILLAC COMMUNITY HEALTH CENTERS
Doing business as
DEPAUL COMMUNITY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 23, 2026
Last certification
Feb 23, 2026
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
3700 Tall Pines Dr
New Orleans, LA 70131-8432

National Provider Directory

National Provider Directory
Tax ID family
Marillac Comm HLTH Centers70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Ellen Kron Individual OtherBoard Member Jan 1, 2017
Anthony R Gardner Individual OtherBoard Member Jan 1, 2017
Wendy Rios-Wood Individual W-2 Managing EmployeeDelegated Official Aug 1, 2022
Michael Deyoung Individual OtherBoard Member Jan 1, 2017
Roderic Teamer Individual OtherBoard Member Jan 1, 2017
Ronald Carrere Individual OtherBoard Member Jan 1, 2017
Sarah Moody-Thomas Individual OtherBoard Member Jan 1, 2017
Flori Hicks Individual OtherBoard Member Jan 1, 2017
Stephanie Navarre Individual OtherBoard Member Jan 1, 2017
Marjorie Hebert Individual OtherBoard Member Jan 1, 2017
Catherine Kelly Individual OtherBoard Member Jan 1, 2017
Michael Griffin Individual Corporate DirectorPresident - Ceo Apr 1, 2008
W-2 Managing EmployeeAd; Apr 1, 2008
Robert Angelico Individual OtherBoard Member Jan 1, 2017
Jedidah Jackson Individual OtherBoard Member Jan 1, 2017

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Depaul Community Health CentersNew Orleans, LA, CCN 191974 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 15, 2010

NPI Registry JSON

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1285249185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13038",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701853038",
            "telephone_number": "504-207-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 TALL PINES DR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701318432",
            "telephone_number": "504-207-3064",
            "fax_number": "504-282-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILLAC COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-09",
        "last_updated": "2022-11-22",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "504-207-3060"
    },
    "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": "DePaul Community Health Centers-Dwight D. Eisenhower Charter School",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DePaul Community Health Centers-Dwight D. Eisenhower Charter School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.