TECHE ACTION BOARD, INC. (NPI# 1902082811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902082811 |
| Entity Type | Organization |
| Organization Name | TECHE ACTION BOARD, INC. |
| Other Organization Name | WEST ST. MARY SCHOOL BASED HEALTH CENTER |
| Practice Address |
18331 Highway 182 Baldwin LA 70514-1449 |
| Mailing Address |
1115 Weber St Franklin LA 70538-4124 |
| Practice Telephone | 3379249418 |
| Practice Fax Number | 3379249165 |
| Mailing Telephone | 3378282550 |
| Mailing Fax Number | 3373552335 |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2016-07-20 |
| Authorized Official Name | DR. GARY M WILTZ (CEO) |
| Authorized Official Telephone | 3378282550 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | TECHE ACTION BOARD, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
========= | LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1908347 | 05 |
| Other Name | Type Code |
|---|---|
| West St. Mary School Based Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912354176 | Teche Action Board, Inc. | Clinic/Center | 2555 La Hwy 18, Edgard, LA 70049-2417 | 2016-05-18 |
| 1215354014 | Teche Action Board, Inc. | Clinic/Center | 121 West 134th Place, Galliano, LA 70354 | 2014-03-19 |
| 1154368553 | Teche Action Board, Inc. | Clinic/Center | 159 E 3rd St, Edgard, LA 70049-2450 | 2006-06-02 |
| 1215974019 | Teche Action Board, Inc. | Clinic/Center | 1014 West Tunnel Blvd, Houma, LA 70360-5555 | 2006-06-01 |
| 1760016562 | Teche Action Board, Inc. | Pharmacist | 1124 7th St, Morgan City, LA 70380 | 2020-03-02 |
| 1639702087 | Teche Action Board, Inc. | Pharmacy | 1124 7th St, Morgan City, LA 70380-1951 | 2020-02-13 |
| 1801433883 | Teche Action Board, Inc. | Clinic/Center | 827 N Pine St, Gramercy, LA 70052-3602 | 2019-12-09 |
| 1255788428 | Teche Action Board, Inc. | Clinic/Center | 1 Wildcat Dr, Reserve, LA 70084-5800 | 2016-05-18 |
| 1477900637 | Teche Action Board, Inc. | Clinic/Center | 393 Greenwood Dr, La Place, LA 70068-2535 | 2016-05-18 |
| 1396121117 | Teche Action Board, Inc. | Clinic/Center | 1124 7th St, Morgan City, LA 70380-1951 | 2015-08-04 |
| Street Address |
18331 HIGHWAY 182 |
| City | BALDWIN |
| State | LA |
| Zip Code | 70514-1449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649678574 | Latambara Joy Swan-wesley | Counselor | 18331 Hwy 182 W, Baldwin, LA 70514 | 2014-12-09 |
| 1538494315 | Laura Duval Gros | Physician Assistant | 18331 Hwy 182 West, Baldwin, LA 70514 | 2009-10-12 |
| 1407060494 | Premier Community Services, LLC | Day Training, Developmentally Disabled Services | 105 Rosebud St, Baldwin, LA 70514 | 2007-05-09 |
| 1437363801 | Premier Community Services, LLC | Day Training, Developmentally Disabled Services | 105 Rosebud Street, Baldwin, LA 70514 | 2007-05-09 |
| 1124579560 | Lakeisha Bob | Counselor | 106 John Street, Baldwin, LA 70514 | 2016-10-20 |
| 1619330776 | Premier Counseling & Parenting Incorporated | Community/Behavioral Health | 105 Rosebud Street, Baldwin, LA 70514 | 2016-04-05 |
| 1447654231 | Premier Community Services | Technician | 105 Rosebud Street, Baldwin, LA 70514 | 2014-10-22 |
| 1053526335 | Premier Community Services, LLC. | Day Training, Developmentally Disabled Services | 105 Rosebud Street, Baldwin, LA 70514 | 2007-05-11 |
| 1164636155 | Premier Community Services, LLC | Day Training, Developmentally Disabled Services | 105 Rosebud Street, Baldwin, LA 70514 | 2007-05-09 |
| 1982836656 | Stacie B Migues | Nurse Practitioner | 100 Live Oak St, Baldwin, LA 70514-0000 | 2009-08-14 |
| Find all providers in zip 70514 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.