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Organization
IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY
Active
Organization
IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY
Active
Parent organization
IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY
Other names
LCBHC Childrens Outreach Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY
Authorized official
MS. TANYA MCGEE LAC (EXECUTIVE DIRECTOR)
(337) 475-3100
Entity
Organization
Contact information
Practice address
3505 5TH AVE, SUITE C, LAKE CHARLES, LA 70607-2156
(337) 475-3100
(337) 475-3105
Mailing address
3505 5TH AVE, SUITE C, LAKE CHARLES, LA 70607-2156
(337) 475-3100
(337) 475-3105
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
95
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710041
—
LA
Enumeration date
10/23/2013
Last updated
10/23/2013
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