Organization
EXTRAORDINARY HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR LATASHA GRICE DNP,FNP-C, PMHNP-BC (OWNER)
(337) 377-8277
Entity
Organization
Contact information
Practice address
900 RYAN ST STE 400, LAKE CHARLES, LA 70601-9405
(337) 377-8277
Mailing address
1130 CAESARS CT, LAKE CHARLES, LA 70611-6739
(337) 377-8277
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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