Organization
OUR LADY OF THE LAKE HOSPITAL INC
Active
Parent organization
OUR LADY OF THE LAKE HOSPITAL INC
Other names
Child Asessment Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
OUR LADY OF THE LAKE HOSPITAL INC
Authorized official
TERRIE P STERLING (COO)
(225) 765-6898
Entity
Organization
Contact information
Practice address
8415 GOODWOOD BLVD, STE 200, BATON ROUGE, LA 70806-7851
(225) 765-8674
(225) 765-4062
Mailing address
8415 GOODWOOD BLVD, STE 105, BATON ROUGE, LA 70806-7851
(225) 765-5727
(225) 765-9244
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06828887
—
MS
05
—
1113069
—
LA
Enumeration date
05/19/2006
Last updated
04/15/2011
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