# LAKE AREA MEDICAL SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083088991
- **Authorized official:** MR. MICHAEL JOSEPH BERTRAND JR. LPN (OWNER/MANAGER)
- **Authorized official phone:** (337) 532-1829

## Contact information

- **Practice address:** 2420 COUNTRY CLUD RD, LAKE CHARLES, LA 70605
- **Practice address phone:** (337) 532-1829
- **Practice address fax:** (337) 240-8882
- **Mailing address:** 900 COUNTRY CLUB ROAD, LAKE CHARLES, LA 70605
- **Mailing address phone:** (337) 532-1829
- **Mailing address fax:** (337) 240-8882

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | 20130793 | LA | Yes |
| 251J00000X | Nursing Care Agency | 20130793 | LA | — |
| 376K00000X | Nurse's Aide | 20130793 | LA | — |

## Other

- **Enumeration date:** 11/17/2015
- **Last updated:** 11/17/2015