Access Health Louisiana
Organization Active NPI Federally Qualified Health Center (FQHC) · Glenmora, LA
NPI 1730809138 · NPPES record last updated Sep 6, 2022
Key facts
- NPI
- 1730809138
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- ACCESS HEALTH LOUISIANA
- Practice address
- 1518 7TH Ave
Glenmora, LA 71433-4027 - Phone
- (866) 530-6111
- NPI assigned
- Aug 29, 2022
- Organization subpart
- No
Authorized official
- Name
- Mark Keiser
- Title
- Ceo
- Phone
- (504) 575-3700
Corporate family (same tax ID) 24
Practitioners 1
-
Kaleen Tran, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Federally qualified health center certification: CCN 191137
- Legal name
- ACCESS HEALTH LOUISIANA
- Doing business as
- GLENMORA HIGH SBHC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Aug 3, 2023
- Last certification
- Aug 3, 2023
- Ownership / control type
- For profit – corporation
- Organization structure
- Other · Non-profit
- Incorporated
- Mar 1, 2002 in LA
- Enrollment address
- 1518 7TH Ave
Glenmora, LA 71433-4027
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Peter Torsch |
Corporate Officer |
Nov 19, 2015 | |
| Corporate Director |
Nov 19, 2015 | ||
| Mark Francis Keiser |
Corporate Officer |
Mar 1, 2002 | |
| Corporate Director |
Mar 1, 2002 | ||
| W-2 Managing Employee |
Mar 1, 2002 | ||
| John Cressend Schonberg |
Corporate Officer |
Mar 1, 2002 | |
| Timothy J. Vial |
Corporate Officer |
Mar 1, 2002 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| St James Alternative School SBHC |
Federally qualified health center | Operational/Managerial Control | Apr 1, 2003 |
| Kenner Community Health Center |
Federally qualified health center | Operational/Managerial Control | Apr 1, 2003 |
| Luling Elementary School SBHC |
Federally qualified health center | Operational/Managerial Control | Apr 1, 2003 |
| Destrehan HS SBHC |
Federally qualified health center | Operational/Managerial Control | Apr 1, 2003 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230824002290 | LA | Part a Provider - Federally Qualified Health Center (FQHC) | 3678484276 | Practice locations: Glenmora, LA |
National Provider Directory
- Tax ID family
- Access Health Lousisana
Locations
320 1st St N
Ste 101
Jacksonville Beach, FL 32250
Phone (866) 923-5038
1518 7th Ave
Glenmora, LA 71433
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
1518 7TH Ave
Glenmora, LA 71433-4027
Mailing address
2900 Indiana Ave
Kenner, LA 70065-4605
Phone (504) 575-3712
Other names
- Glenmora High SBHC
Other providers in Glenmora, LA
- Christus Health Central Louisiana
- Amanda Damewood
- Dove Family Clinic, Inc
- Darlinda Theresa Dove
- Trinity Renee' English
All providers in Glenmora, LA · Federally Qualified Health Center (FQHC) in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.