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NPI Code Detail

MEDICARE: SWLA CENTER FOR HEALTH SERVICES

MEDICARE: SWLA CENTER FOR HEALTH SERVICES
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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376725952
Entity Type Code : Organization
Provider Name (Legal Business Name) : SWLA CENTER FOR HEALTH SERVICES
Provider Business Mailing Address
First Line : 2000 OPELOUSAS STREET
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601
Country : US
Telephone Number : 337-439-9983
Fax Number : 337-497-2556
Provider Business Practice Location Address
First Line : 500 PATTERSON ST
Second Line :
City : LAFAYETTE
State : LA
Zip : 70501-1849
Country : US
Telephone Number : 337-769-9451
Fax Number : 337-769-9460
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : JAMYA A MOUTON
Credential :
Telephone Number : 337-769-9451
Provider Enumeration Date : 12/05/2007
Last Update Date : 03/27/2025

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Directions to “SWLA CENTER FOR HEALTH SERVICES ” Practice Location

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