Organization
NORMAL LIFE OF LAKE CHARLES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY A PANK (PARALEGAL)
(502) 394-2100
Entity
Organization
Contact information
Practice address
529 SAINT JOHN ST, LAFAYETTE, LA 70501-5709
(337) 233-2731
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
(502) 394-2100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1569623
—
LA
Enumeration date
05/24/2007
Last updated
08/05/2025
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