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CHC26579-02 C A S S E DENTAL HEALTH INSTITUTE (Active)
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Main Details
Name
C A S S E DENTAL HEALTH INSTITUTE
Subdivision Name
CASSE-Bert Kouns Site
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013673
340B ID
CHC26579-02
Grant Number
H80CS26579
Additional Details
Current Program Status
Active
Registration Date
4/3/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/5/2018
Last Recertification Date
2/20/2025
Contacts
Authorizing Official
CASSE
Beth Chumley, CEO
(318) 688-3350
Primary Contact
CASSE Dental Health Institute
Tisha M Dennis, Contract & Coordinator of Operations
(318) 688-3350
Addresses
Street Address
2120 Bert Kouns
Ste. A
Shreveport, LA 71118-3354
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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Initial start 10/1/2015, Termination date 4/1/2018, Reinstate 7/1/2018
04/04/2018
April 2025
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