Organization
LAKE WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE ROUSSEL (OWNER)
(337) 703-0880
Entity
Organization
Contact information
Practice address
19411 HELENBIRG RD STE 101, COVINGTON, LA 70433-5199
(985) 602-5253
(985) 317-2323
Mailing address
PO BOX 53038, LAFAYETTE, LA 70505-3038
(337) 781-3408
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/01/2019
Last updated
11/14/2025
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