# SOUTHWEST LOUISIANA INDEPENDENCE CENTER INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** @SLIC, @Southwest Louisiana Independence Center Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144356577
- **Authorized official:** MR. RANDY DARTEZ (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (337) 274-8590

## Contact information

- **Practice address:** 216 A LA RUE FRANCE, LAFAYETTE, LA 70508
- **Practice address phone:** (337) 269-0027
- **Practice address fax:** (337) 233-7660
- **Mailing address:** 4320 LAKE ST., LAKE CHARLES, LA 70605
- **Mailing address phone:** (337) 477-7194
- **Mailing address fax:** (337) 477-7194

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | 12803 | LA | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/27/2007
- **Last updated:** 09/06/2023