NPIMap

Jefferson Community Health Care Centers, Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Marrero, LA

NPI 1447517032 · NPPES record last updated Apr 19, 2012

Key facts

NPI
1447517032
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC
Practice address
4300 Patriot St
Marrero, LA 70072-4305
Phone
(504) 762-8909
Fax
(504) 328-0899
NPI assigned
Apr 19, 2012
Organization subpart
No

Authorized official

Name
Dr. Cyrous Ardalan, DDS
Title
Interim Ceo
Phone
(504) 762-8900

Corporate family (same tax ID) 15

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

National Provider Directory

Tax ID family
Inclusivcare (16 organizations share this tax ID)

Locations

4300 Patriot St
Marrero, LA 70072
Phone (504) 371-1318

Specialties & licenses

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

Addresses

Primary practice location

4300 Patriot St
Marrero, LA 70072-4305

Mailing address

PO Box 2490
Marrero, LA 70073-2490
Phone (504) 762-8900

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 19, 2012.

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1447517032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2490",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700732490",
            "telephone_number": "504-762-8900",
            "fax_number": "504-328-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 PATRIOT ST",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700724305",
            "telephone_number": "504-762-8909",
            "fax_number": "504-328-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON COMMUNITY HEALTH CARE CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "ARDALAN",
        "authorized_official_first_name": "CYROUS",
        "authorized_official_title_or_position": "INTERIM CEO",
        "authorized_official_telephone_number": "504-762-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

All providers in Marrero, LA · Federally Qualified Health Center (FQHC) in Louisiana

Sources for this page

Verify at the official NPI Registry.