Organization
SAINT RAPHAEL'S REFUGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY SUZANNE KERLEGON LPC-S (OWNER)
(337) 304-2387
Entity
Organization
Contact information
Practice address
1155 HODGES ST, LAKE CHARLES, LA 70601-5215
(337) 304-2387
Mailing address
1155 HODGES ST, LAKE CHARLES, LA 70601-5215
(337) 304-2387
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4478
LA
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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