Organization
LAKE CHARLES ADDICTION AND WELLNESS CENTER
Active
Other names
Addiction and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE L BOYD LAC (OWNER)
(337) 513-6121
Entity
Organization
Contact information
Practice address
315 ALAMO ST, LAKE CHARLES, LA 70601-8528
(337) 513-6121
Mailing address
2789 CROWN LN, LAKE CHARLES, LA 70605-8135
(337) 513-6121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184754723
—
DE
05
—
1447703251
—
LA
05
—
1457807828
—
LA
Enumeration date
12/30/2019
Last updated
08/27/2024
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