Healthcare Provider Details

I. General information

NPI: 1932248812
Provider Name (Legal Business Name): CALCASIEU PARISH VOLUNTARY COUNCIL ON AGING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 GERSTNER MEMORIAL BLVD
LAKE CHARLES LA
70607-3852
US

IV. Provider business mailing address

3950 GERSTNER MEMORIAL BLVD
LAKE CHARLES LA
70607-3852
US

V. Phone/Fax

Practice location:
  • Phone: 337-474-2583
  • Fax: 337-474-6563
Mailing address:
  • Phone: 337-474-2583
  • Fax: 337-474-6563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateLA

VIII. Authorized Official

Name: MRS. DEBBIE L. DUHON
Title or Position: PROGRAM MANAGER
Credential:
Phone: 337-474-2583