NPI 1104871425

Department of Health and Hospitals

Organisation Substance Abuse Rehabilitation Facility Lake Charles, LA

Practice location

Address: 4012 Avenue H, Lake Charles, LA 70615-5186
Phone: (337) 491-2355
Fax: (337) 491-2492

Authorised official

Name: Jemece Michelle Richard
Title: Inpatient Manager
Phone: (337) 491-2355

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence 044 (LA)

Other Substance Abuse Rehabilitation Facility providers in Louisiana →

Registry record

NPI: 1104871425
Entity type: Organization
NPI issued: 24 May 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.