Federally Qualified Health Center Fee Schedule - State Fiscal Year 2016

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1 Clinic Name Clinic Address Rate NPI Abbeville Community Health Center 800 Charity Street, Abbeville, LA $ Access Health Louisiana Kenner 2900 Indiana Avenue, Kenner, LA $ AHL SBHC Paradis 434 South Street, Paradis, LA $ Albert Cammon Wellness Center 232 Pirate Drive, St Rose, LA $ Avoyelles Primary Health and Wellness Center 1007 Shirley Road, Bunkie, LA $ Bastrop High School Based Health Center 402 Highland Avenue, Baton Rouge, LA $ Baton Rouge Primary Care Collaborative 153 North 17th Street, Baton Rouge, LA $ Baton Rouge Primary Care Collaborative 2013 Central Road, Suite B, Baton Rouge, LA $ Belle Chasse Community Health Center 8200 Highway 23, Belle Chasse, LA $ Bienville Community Health Center 2826 Bienville Road, Ringgold, LA $ Bonnabel High School SBHC Mental Health Services 2801 Bruin Drive, Kenner, LA $ Capital City Family Health Center 3140 Florida Boulevard, Baton Rouge, LA $ Capitol City Family Health Center Plaquemine Riverwest Drive, Ste A & B, Plaquemine, LA $ Capitol City Family Health Center, Inc 904 Catalpa Street, Donaldsonville, LA $ CASSE/Community Health Institute 907 Polk Street, Mansfield, LA $ CASSE- Bert Kouns Site 2120 Bert Kouns, Suite A, Shreveport, LA $ Catahoula Parish Hospital District #2 307 Chisum Street, Sicily Island, LA $ Clinton Lower Health Center Reiley Street, Clinton, LA $ Clinton Middle Health Center Plank Road, Clinton, LA $ Cohen College Prep High School SBHC 3520 Fryades Street, New Orleans, LA $ Colfax School Based Clinic 301 3rd Street, Colfax, La $ Common Ground Health Clinic 1400 Teche Street, New Orleans, LA $ Concordia Community Health Center 100 Serio Boulevard, Ferriday, LA $ Crescent Care Health and Wellness Center 3308 Tulane Avenue, New Orleans, LA $ Crescent Care Specialty Center 2601 Tulane Avenue, Suite 500, New Orleans, LA $ Daughters of Charity Health Centers 3512 Louisa Street, New Orleans, LA $ Daughters of Charity Health Center Carrollton 3201 S Carrollton, New Orleans, LA $ Daughters of Charity Health Center Gentilly 100 Warrington Drive, Suite B, New Orleans, LA $

2 Daughters of Charity Health Center Metairie 111 N Causeway Boulevard, Metairie, LA $ Daughters of Charity Health Center New Orleans East 5630 Read Boulevard, Suite B, New Orleans, LA $ Daughters of Charity Health Center St Cecilia 1030 Lesseps Street, New Orleans, LA $ David Raines Community Health Center 3021 W 70th Street, Shreveport, LA $ David Raines Community Health Center Bossier 1514 Doctors Drive, Bossier City, LA $ David Raines Community Health Gilliam Lay Street, Gilliam, LA $ David Raines Community Health Center Haynesville 1953 East Main Street, Haynesville, LA $ David Raines Community Health Center Minden 128 Homer Road, Minden, LA $ David Raines Community Health Center Shreveport 1625 David Raines Rd, Shreveport, LA $ Delhi Community Health Center 109 Elm Street, Delhi, LA $ Delhi Community School Based Center Delhi Charter 6940 Highway 17, Delhi, LA $ Delhi Community School Based Center Delhi Elementary & High 509 Main Street, Delhi, LA $ Delhi Community School Based Center Delhi Middle 106 Toombs Street, Delhi, LA $ East Iberville Elem High SBHC 3285 Highway 75, St. Gabriel, LA $ Evangeline Family Medicine 505 E Lincoln Road, Ville Platte, LA $ Excelth Family Dental Center Algiers 1111 Newton Street, Ste 207, New Orleans, LA $ Excelth Family Health Center 4560 North Boulevard, Ste 108, Baton Rouge, LA $ Excelth Family Health Center Algiers 4422 Gen Meyer Avenue Ste 103, New Orleans, LA $ Excelth Family Health Center East 9900 Lakeforest Boulevard, New Orleans, LA $ Excelth Family Health Center Gentilly 2050 Caton Street, New Orleans, LA $ Family Care Services Center 4640 S Carrollton, Suite 120, New Orleans, LA $ Family Health Care Clinic, Inc 1495 US Highway 61 South, Woodville, MS $ Family Health Care Clinic, Inc 609 Superior Avenue, Bogalusa, LA $ Georgetown School Based Clinic 4528 Highway 500, Georgetown, LA $ Grant Community Health Center 340 Webb Smith Drive, Colfax, LA $ HCH Community Resources and Referral Center 1530 Gravier Street, New Orleans, LA $ Iberia Comprehensive Community Health Center Inc. 806 Jefferson Terrace, New Iberia, LA $ Innis Community Health Center 6450 LA Highway 1, Batchelor, LA $ Jackson Complex Health Center 3501 Highway 10, Jackson, LA $ JeffCare East Jefferson 3616 S I-10 Service Road, Suite 100, Metairie, LA $

3 JeffCare West Jefferson 5001 Westbank Expressway, Suite 100, Marrero, LA $ Jefferson Community Health Care Avondale 4028 US Highway 90, Avondale, LA $ Jefferson Community Health Care Center Marrero 1855 Ames Boulevard #B, Marrero, LA $ Jefferson Community Health Care River Ridge Jefferson Highway, River Ridge, LA $ John Ehret School Based Health Center Mental Health Services 4300 Patriot Street, Marrero, LA $ Jonesville Medical Center 900 Foster Street, Jonesville, LA $ Joshua Butler School Based Health Center Mental Health Services 300 4th Street, Westwego, LA $ Kenner Community Health Center 1401 West Esplanade Avenue, Suite 108-A, Kenner, LA $ L.B. Landry Community Clinic 1200 LB Landry Avenue, New Orleans, LA $ Livonia Community Health Center 3041 Fordoche Road, Livonia, LA $ Livonia High School 3118 LA Highway 78, Livonia, LA $ Livonia School Based Health Center 8387 Newfield Drive, Livonia, LA $ Maringouin Community Health Center Wagley Road, Maringouin, LA $ Math Science and Arts Academy East Campus 1825 Highway 30, Street Gabriel, LA $ Merryville Community Health Center 567 Walker Street, Merryville, LA $ Montgomery School Based Clinic 900 Harrison Drive, Montgomery, LA $ Morehouse Community Medical Centers Bastrop 518 Durham Street, Bastrop, LA $ Morehouse Community Medical Centers Dental Site 625 South Washington Street Bastrop, LA $ Morehouse Community Medical Centers Marion 3150 Taylor Street, Marion, LA $ Morehouse Community Medical Centers Mer Rouge 108 North 16th Street, Mer Rouge, LA $ Morehouse Jr. High SBHC 1001 W Madison Avenue, Bastrop, LA $ MQVN CDC Chef Menteur Highway, New Orleans, LA $ N.O.H.D.-H.C.H.P Simon Bolivar, 2nd FLR, New Orleans, LA $ Northside Community Health Center 1800 Louisiana Avenue, Lafayette, LA $ Outpatient Medical Center Leesville 1603 B Boone Street, Leesville, LA $ Outpatient Medical Center Natchitoches 1640 Breazeale Springs Street, Natchitoches, LA $ Outpatient Medical Center Tallulah 804 Beech Street, Tallulah, LA $ Pointe Coupee Central High School Based Clinic 8434 Pointe Coupee Road, Morganza, LA $ Primary Health Services Center 2913 Desiard Street, Monroe, LA $ Primary Health Services Center 2914 Betin Avenue, Monroe, LA $

4 Primary Health Services Center 2915 Betin Avenue, Monroe, LA $ Primary Health Services Center 850 South 2nd Street, Monroe, LA $ Priority Health Care 12A Westbank Expressway, Suite , Gretna, LA $ Priority Health Care 4700 Wichers Drive, Suite , Marrero, LA $ Rapides Primary Health Care Center 1217 Willow Glen River Road, Alexandria, LA $ RFK Lafitte Medical Clinic 5140 Church Street, Lafitte, LA $ Riser Middle School Based Health Center 100 Price Drive, West Monroe, LA $ Riverdale School Based Health Center Mental Health Services 240 Riverdale Drive, Jefferson, LA $ RKM Primary Care Jackson, Street, Clinton, LA $ RKM Primary Care Livingston Highway 63 Ste 14, Livingston, LA $ RKM Primary Care Springfield Highway 42, Springfield, LA $ Rosenwald Elementary School 1100 New Roads Street, New Roads, LA $ Rougon Elementary School LA Highway 416, Rougon, LA $ Ruth U Fertel/Tulane Community Health Center 711 N Broad Street, New Orleans, LA 70119` $ Sabine Comprehensive Health Clinic 1050 N Robinson Street, Many, LA $ Slaughter Health Center 3170 Church Street, Slaughter, LA $ South Broad Community Health 3300 South Broad Street, New Orleans, LA $ South Grant School Based Clinic 1000 Highway 1241 Dry Prong, LA $ Southeast Community Health System Albany Old Baton Rouge Highway, Albany, LA $ Southeast Community Health System Greensburg 490 Sitman Street, Greensburg, LA $ Southeast Community Health Systems Independence Berry Bowl Road, Independence, LA $ Southeast Community Health System Kentwood 721 Avenue G, Kentwood, LA $ Southeast Community Health System- Zachary 6351 Main Street, Zachary, LA $ St Bernard Community Health Center 8050 West Judge Perez Drive, Chalmette, LA $ St Charles Community Health Center Kenner 200 W Esplanade Avenue # , Kenner, LA $ St Charles Community Health Center Luling 843 Milling Avenue, Luling, LA $ St Charles Community Health Center Norco River Road, Norco, LA $ St Charles Community Health Center Paul Maillard 1057 Paul Maillard, Ste 240, Luling, LA $ St Gabriel Health Clinic 5760 Monticello Street, St. Gabriel, LA $ St Gabriel Health Clinic Gardere Site 1707 Gardere Lane, Baton Rouge, La $

5 St Helena Arts and Technology Academy 1798 Highway 1042, Greensburg, LA $ St Helena College and Career Academy Highway 37,Greensburg, LA $ St Martin Community Health Center 317 Dernier Street, St. Martinville, LA $ St Tammany Community Health Center Covington 1301 Florida Avenue, Covington, LA $ St Tammany Community Health Center 501 Robert Boulevard, Slidell, LA $ St Thomas Community Health Center 1020 St. Andrew Street, New Orleans, LA $ St. Thomas Community Health Center 2405 Jackson Avenue, New Orleans, LA $ St Thomas Community Health Center 1936 Magazine Street, New Orleans, LA $ St Thomas Community Health Center 3943 Saint Bernard Avenue, New Orleans, LA $ Start Community Health Center 420 Magnolia Street, Houma, LA $ Surrey Street Community Health Center th Street, Lafayette, LA $ Surrey Street Community Health Center 1004 Surrey Street, Lafayette, LA $ SWLA Primary Health Care Clinic Opelousas 8762 Highway 182 North, Opelousas, LA $ SWLA Center for Health Services Oberlin 112 South Sixth Street, Oberlin, LA $ SWLA Center for Health Services Crowley 613 John F Kennedy Drive, Crowley, LA $ SWLA Center for Health Services Lafayette 500 Patterson Street, Lafayette, LA $ SWLA Center for Health Services Lake Charles 2000 Opelousas Street, Lake Charles, LA $ Tangipahoa CHC Phyllis Ann Drive, Hammond, LA $ Trinity Counseling and Training Center 2108 Coliseum Street, New Orleans, LA $ Teche Action Clinic Dulac 189 Mozart Drive, Houma, LA $ Teche Action Clinic Edgard 159 East Third Street, Edgard, LA $ Teche Action Clinic Franklin 1115 Weber Street, Franklin, LA $ Teche Action Clinic Galliano 121 West 134 th Place, Galliano, LA $ Teche Action Clinic Houma 1014 West Tunnel Boulevard, Houma, LA $ Teche Action Clinic Morgan City 1124 Seventh Street, Morgan City, LA $ Teche Action Clinic Pierre Part 3617 Highway 70 South, Pierre Part, LA $ Teche Action Clinic Reserve 471 Central Avenue, Reserve, LA $ Teche Action Clinic Thibobaux 1709 Ridgefield Road, Thibodaux, LA $ Tensas Community Health Center Inc 1115 Levee Road, St. Joseph, LA $ Tulane Avenue Primary Care Center 1415 Tulane Avenue 6th Floor, New Orleans, LA $

6 Upper Pointe Coupee Elementary School 4739 LA Highway 419, Batchelor, LA $ Valverda Elementary School 1653 Valverda Road, Maringouin, LA $ Verda School Based Clinic 2580 Highway 122, Montgomery, LA $ Warren Easton High School SBHC 3036 Iberville Street, New Orleans, LA $ Washington Community Health Center 2807 South Columbia Street, Bogalusa, LA $ West Baton Rouge Primary Care 751 Court Street, Port Allen, LA $ West Jefferson School Based Health Center Mental Health Services th Street, Harvey, LA $ West Monroe High School 201 Riggs Street, West Monroe, LA $ West St. Mary School Based Health Center Highway 182 West, Baldwin, LA $ Winn Community Dental Center 425 West Lafayette Street, Winfield, LA $ Winn Community Health Center 431 West Lafayette Street, Winnfield, LA $ Winn Primary School Based Clinic 400 South St John Street, Winnfield, LA $ Wisner Medical Clinic 126 Watson Street, Wisner, LA $ WoodWorth Community Health Center 9372 Highway 165 South, Woodworth, LA $ The rates listed above are Medicaid rates only. Medicare rates are determined by Department of Health and Human Services via the Centers for Medicare and Medicaid Services (CMS). Please see the link that follows which contains information on increased Medicare rates for the clinics listed above. Louisiana is not the author of CMS publications and the addition of Medicare information is not intended to grant rights or impose obligations. The information is not intended to take the place of either the written law or regulations.