Healthcare Provider Details

I. General information

NPI: 1669608097
Provider Name (Legal Business Name): CONSUMER ADVOCACY AND RESOURCE COORDINATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2009
Last Update Date: 05/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 CANVASBACK STREET
LAKE CHARLES LA
70615
US

IV. Provider business mailing address

4100 J. BENNETT JOHNSTON AVENUE
LAKE CHARLES LA
70615-5166
US

V. Phone/Fax

Practice location:
  • Phone: 337-433-7792
  • Fax: 337-433-5181
Mailing address:
  • Phone: 337-433-7792
  • Fax: 337-433-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number27014
License Number StateLA

VIII. Authorized Official

Name: HOWARD STROUD JR.
Title or Position: EXECUTIVE DIRECTOR
Credential: EDD
Phone: 337-433-3620