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CHC26579-05 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 - DIAMC Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030775
340B ID
CHC26579-05
Grant Number
H80CS26579
Additional Details
Current Program Status
Active
Registration Date
3/15/2021
Participating Start Date
4/1/2021
Participating Approval Date
3/16/2021
Last Recertification Date
2/21/2025
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
1560 Irving Pl
Shreveport, LA 71101-4604
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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