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NPI Code Detail

MEDICARE: ELITE MEDICAL WELLNESS LLC

MEDICARE: ELITE MEDICAL WELLNESS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1346644606
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELITE MEDICAL WELLNESS LLC
Provider Business Mailing Address
First Line : 2802 HODGES ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-7368
Country : US
Telephone Number : 337-419-1873
Fax Number : 337-656-2848
Provider Business Practice Location Address
First Line : 2802 HODGES ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-7368
Country : US
Telephone Number : 337-419-1873
Fax Number : 337-656-2848
Authorized Official
Title or Position : M.D./OWNER
Name : DR. PATRICK HAYES
Credential : M.D.
Telephone Number : 337-419-1873
Provider Enumeration Date : 10/15/2014
Last Update Date : 11/28/2022

Similar Medicare Providers

1619052461 — DR. PATRICK CHARLES HAYES MD
Practice Location Address:
2802 HODGES ST
LAKE CHARLES, LA
70601-7368
Practice Phone: 337-419-1873
Practice Fax: 337-656-2848
1831212943 — MRS. IVA K. CONDE APRN, PMHNP-BC
Practice Location Address:
2802 HODGES ST
LAKE CHARLES, LA
70601-7368
Practice Phone: 337-419-1873
Practice Fax:
1053743757 — MR. BRETT MICHAEL CHAMBLEY M.A LPC
Practice Location Address:
2802 HODGES ST
LAKE CHARLES, LA
70601-7368
Practice Phone: 337-419-1873
Practice Fax:
1639557606 — JACQUELINE BOURASSA
Practice Location Address:
2802 HODGES ST
LAKE CHARLES, LA
70601-7368
Practice Phone: 337-419-1873
Practice Fax: 337-656-2848
1881131266 — KRISTIN SEGURA APRN, NP
Practice Location Address:
2802 HODGES ST
LAKE CHARLES, LA
70601-7368
Practice Phone: 337-419-1873
Practice Fax:
1558857342 — AMANDA M MORIN
Practice Location Address:
2802 HODGES ST
LAKE CHARLES, LA
70601-7368
Practice Phone: 337-419-1873
Practice Fax: 337-656-2848

Directions to “ELITE MEDICAL WELLNESS LLC ” Practice Location

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