Provider Demographics
NPI:1730628975
Name:CLHG-OAKDALE, LLC
Entity type:Organization
Organization Name:CLHG-OAKDALE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SUZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:FATULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-215-3223
Mailing Address - Street 1:130 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:LA
Mailing Address - Zip Code:71463-3035
Mailing Address - Country:US
Mailing Address - Phone:318-215-3431
Mailing Address - Fax:318-215-3024
Practice Address - Street 1:1884 HIGHWAY 165 S
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463-3500
Practice Address - Country:US
Practice Address - Phone:318-335-3501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty