Grace Health Clinic

LBN: Grace Health Clinic
Grace Health Clinic is an health care organization with primary practice located at 1415 Corporate Square Dr Ste A , Slidell LA 70458-3151. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Grace Health Clinic can be contacted via phone (985) 259-4854, or through Jackson, Bianca D via phone (985) 259-4854.

Contact Information

Primary practice address
1415 Corporate Square Dr Ste A Slidell LA 70458-3151
Phone: (985) 259-4854
Fax: (855) 807-4750
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Bianca D
Phone: (985) 259-4854

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1295290963
LBN Legal business name Grace Health Clinic
DBA Doing business as
Authorized official Jackson, Bianca D
Entity Organization
Organization subpart 1 No
Enumeration date Feb 6th, 2019
Last updated Jun 17th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295290963 NPPES
Mississippi MEDICAID 05427361
Mississippi MEDICAID 2427806

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