| NPI | 1144705930 |
|---|---|
| Doing Business As | DAVID RAINES COMMUNITY HEALTH CENTER - MOBILE DENTAL |
| Entity Type | Organization |
| Authorized Contact | WILLIE C WHITE Chief Executive Officer 318-227-3350 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2018-09-27 |