Organization Active NPI

Marillac Community Health Centers

Doing business as DePaul Community Health Centers-St. Leo the Great School

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
National Provider Identifier
1437622735
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-St. Leo the Great School
Practice address
1501 Abundance St
New Orleans, LA 70119-2052
Phone
(504) 282-0089
NPI assigned
Jan 9, 2019
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) 207-3059

Specialties & licenses 1

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

Addresses

Primary practice location

1501 Abundance St
New Orleans, LA 70119-2052

Mailing address

PO Box 13038
New Orleans, LA 70185-3038

Other names 1

  • DePaul Community Health Centers-St. Leo the Great School Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250429000056 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 1437622735. Details of each certification follow.

Federally qualified health center certification: CCN 711184

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
Apr 10, 2025
Last certification
Apr 10, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1501 Abundance St
New Orleans, LA 70119-2052

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, 2019
Wendy Rios-Wood Individual W-2 Managing EmployeeCredentialing Specialist Jan 1, 2023
Michael Deyoung Individual OtherBoard Member Jan 1, 2019
Roderic Teamer Individual OtherBoard Member Jan 1, 2019
Ronald Carrere Individual OtherBoard Member Jan 1, 2019
Sarah Moody-Thomas Individual OtherBoard Member Jan 1, 2019
Flori Hicks Individual OtherBoard Member Jan 1, 2019
Stephanie Navarre Individual OtherBoard Member Jan 1, 2019
Marjorie Hebert Individual OtherBoard Member Jan 1, 2019
Catherine Kelly Individual OtherBoard Member Jan 1, 2019
Anna Garner Individual OtherBoard Member Jan 1, 2019
Michael Griffin Individual Corporate OfficerPresident-Ceo Jan 1, 2017
Operational/Managerial ControlPresident-Ceo Jan 1, 2017
Robert Angelico Individual OtherBoard Member Jan 1, 2019
Jedidah Jackson Individual OtherBoard Member Jan 1, 2019

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": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1437622735",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 ABUNDANCE ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701192052",
            "telephone_number": "504-282-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILLAC COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "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": "504-207-3059"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DePaul Community Health Centers-St. Leo the Great School",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DePaul Community Health Centers-St. Leo the Great School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.