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Organization
LCMS REHABILITATION INSTITUTE OF SOUTHWEST LOUISIANA
Active
Organization
LCMS REHABILITATION INSTITUTE OF SOUTHWEST LOUISIANA
Active
Parent organization
LAKE CHARLES MEDICAL SERVICES, INC.
Other names
MMG/Moss Campus
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKE CHARLES MEDICAL SERVICES, INC.
Authorized official
DAWN JOHNSON-HATCHER (CFO)
(337) 494-2094
Entity
Organization
Contact information
Practice address
1000 WALTERS ST, LAKE CHARLES, LA 70607-4647
(337) 480-8066
(337) 480-8109
Mailing address
PO BOX 122108 DEPT 2108, DALLAS, TX 75312-2108
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
—
NULL
207RI0200X
Infectious Disease Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
NULL
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
Other
Enumeration date
05/08/2009
Last updated
12/04/2023
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