Healthcare Provider Details

I. General information

NPI: 1356420558
Provider Name (Legal Business Name): HELIOS OUTPATIENT CENTER, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 GAUSE BLVD E SUITE 201
SLIDELL LA
70461-5442
US

IV. Provider business mailing address

1850 GAUSE BLVD E SUITE 201
SLIDELL LA
70461-5442
US

V. Phone/Fax

Practice location:
  • Phone: 985-649-5825
  • Fax: 985-645-0884
Mailing address:
  • Phone: 985-649-5825
  • Fax: 985-645-0884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number119
License Number StateLA

VIII. Authorized Official

Name: CHRISTOPHER YOUNG LEW
Title or Position: OWNER
Credential: M.D.
Phone: 985-649-5825