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General NPI Number Information
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NPI Number | 1215161922
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Entity Type | Organization
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Legal Business Name | LCMS REHABILITATION INSTITUTE OF SOUTHWEST LOUISIANA
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Dates
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Enumeration Date | 05/08/2009
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 1000 WALTERS ST
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City | LAKE CHARLES
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State | LA
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Zip | 70607-4647
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Country | US
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Telephone | 337-480-8066
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Fax | 337-480-8109
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Provider Business Mailing Address
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Address Line | PO BOX 122108 DEPT 2108
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City | DALLAS
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State | TX
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Zip | 75312-2108
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Country | US
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Telephone | 337-494-2921
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Fax | 337-494-6523
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Authorized Official
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Title or Position | CFO
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Name | DAWN JOHNSON-HATCHER
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Credential |
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Telephone | 337-494-2094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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