Organization
TRINA HEALTH OF LAKE CHARLES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY BONO (CHIEF FINANCIAL OFFICER)
(337) 602-6091
Entity
Organization
Contact information
Practice address
1714 WOLF CIRCLE, LAKE CHARLES, LA 70605-4050
(337) 240-9511
(337) 240-9510
Mailing address
630 W PRIEN LAKE RD, STE B-111, LAKE CHARLES, LA 70601-0700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/06/2016
Last updated
10/12/2016
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