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CLHG-Avoyelles LLC

Organization Active NPI Rural Health Clinic/Center · Marksville, LA

NPI 1962924928 · NPPES record last updated Oct 17, 2022

Key facts

NPI
1962924928
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
CLHG-AVOYELLES LLC
Practice address
4239 Highway 1192 Ste 300
Marksville, LA 71351-4772
Phone
(318) 253-0677
Fax
(318) 253-0679
NPI assigned
Jul 12, 2017
Organization subpart
Yes
Parent organization (as reported)
CLHG-AVOYELLES LLC

Authorized official

Name
Timothey Curry
Title
Ceo
Phone
(318) 240-6000

Other NPIs on the same Medicare enrollment 7

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

Other NPIs with the same Medicare PAC ID 8

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

Corporate family (same tax ID) 7

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

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

Facilities with the same owner 53

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 53

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 49

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in LA

Rural health clinic certification: CCN 198505

Legal name
CLHG-AVOYELLES LLC
Doing business as
AVOYELLES HOSPITAL RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 6, 2018
Last certification
Aug 6, 2021
Ownership / control type
For profit – corporation
Organization structure
LLC · Proprietary
Incorporated
Jul 27, 2017 in LA
Enrollment address
4239 Highway 1192
Ste 300
Marksville, LA 71351-4772
Related CCNs
190099

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Donald Cameron
Individual 		5% Or Greater Indirect Ownership Interest Sep 1, 2016 30%
Corporate Officer Sep 1, 2016
Rock Bordelon
Individual 		5% Or Greater Direct Ownership Interest
Owner		 Sep 1, 2016 65%
Allegiance Health Management Inc
Organization · Bossier City, LA
Corporation 		Operational/Managerial Control Mar 17, 2022
Timothey Curry
Individual 		Corporate Director
Chief Executive Officer		 Jun 11, 2018
W-2 Managing Employee
Chief Executive Officer		 Jun 11, 2018
Operational/Managerial Control
Ceo		 Jun 11, 2018 100%
Scott Markstrom
Individual 		5% Or Greater Direct Ownership Interest
Chief Financial Officer		 Sep 1, 2016 5%
Cameron Investments LLC
Organization · Shreveport, LA 		5% Or Greater Direct Ownership Interest Sep 1, 2016 30%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170808002421 LA Part a Provider - Rural Health Clinic 8921380528 Practice locations: Marksville, LA
O20180828001494 LA Part B Supplier - Clinic/Group Practice 8921380528 Receives reassigned benefits from 87 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marksville, LA; Moreauville, LA; Lecompte, LA; Hessmer, LA; Cottonport, LA

National Provider Directory

Tax ID family
CLHG-Avoyelles LLC (8 organizations share this tax ID)
Part of
CLHG-Avoyelles LLC

Locations

409 Choupique Ln
Cottonport, LA 71327
Phone (318) 240-6000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Rural Health Clinic/Center 261QR1300X Yes
Durable Medical Equipment & Medical Supplies 332B00000X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LF0000X
Psychiatric/Mental Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LP0808X

Addresses

Primary practice location

4239 Highway 1192 Ste 300
Marksville, LA 71351-4772

Mailing address

PO Box 249
Marksville, LA 71351-0249
Phone (318) 253-0677

Other names

  • Avoyelles Hospital Rural Health Clinic Doing business as

Other providers in Marksville, LA

All providers in Marksville, LA · Rural Health Clinic/Center in Louisiana

Sources for this page

Verify at the official NPI Registry.