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General NPI Number Information
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NPI Number | 1154456507
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Entity Type | Organization
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Legal Business Name | HEALTH ASSOCIATES OF LAKE CHARLES
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 07/09/2009
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Provider Practice Location Address
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Address Line | 2800 1ST AVE STE A
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City | LAKE CHARLES
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State | LA
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Zip | 70601-8884
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Country | US
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Telephone | 337-491-9880
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Fax | 337-433-3268
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Provider Business Mailing Address
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Address Line | 2800 1ST AVE STE A
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City | LAKE CHARLES
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State | LA
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Zip | 70601-8884
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Country | US
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Telephone | 337-491-9880
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Fax | 337-433-3268
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MRS. CRYSTAL M PARKER
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Credential |
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Telephone | 337-491-9880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | AS3413135
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License Number State | LA
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