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General NPI Number Information
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NPI Number | 1548201437
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE COVENANT ADULT DAY HEALTH CARE INC.
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2120 OAK PARK BLVD
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City | LAKE CHARLES
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State | LA
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Zip | 70601-7864
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Country | US
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Telephone | 337-474-2878
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Fax | 337-474-2875
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Provider Business Mailing Address
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Address Line | PO BOX 1441
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City | LAKE CHARLES
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State | LA
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Zip | 70602-1441
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Country | US
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Telephone | 337-474-2878
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Fax | 337-474-2875
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JULIE H. GUIDRY
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Credential | R.N.
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Telephone | 337-474-2878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 12843
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 4121
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License Number State | LA
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