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Organization
LAKE CHARLES ADDICTION AND WELLNESS CENTER
Active
Organization
LAKE CHARLES ADDICTION AND WELLNESS CENTER
Active
Other names
Addiction and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE L BOYD LAC (OWNER)
(337) 513-6121
Entity
Organization
Contact information
Practice address
315 ALAMO ST, LAKE CHARLES, LA 70601-8528
(337) 513-6121
Mailing address
2789 CROWN LN, LAKE CHARLES, LA 70605-8135
(337) 513-6121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184754723
—
DE
05
—
1447703251
—
LA
05
—
1457807828
—
LA
Enumeration date
12/30/2019
Last updated
08/27/2024
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