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General NPI Number Information
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NPI Number | 1093823890
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Entity Type | Organization
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Legal Business Name | HARBOR HOSPICE OF LAKE CHARLES, LP
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 5210 LAKE ST
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City | LAKE CHARLES
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State | LA
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Zip | 70605-6574
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Country | US
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Telephone | 337-562-8620
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Fax | 337-562-8621
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Provider Business Mailing Address
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Address Line | 3406 COLLEGE ST SUITE 200
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City | BEAUMONT
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State | TX
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Zip | 77701-4612
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Country | US
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Telephone | 409-813-2332
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Fax | 409-232-0573
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Authorized Official
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Title or Position | EXEC ADMIN ASST
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Name | KAREN CARTER
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Credential |
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Telephone | 409-730-2046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 185
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 19-1625
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License Number State | LA
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