Organization
REGIONAL HEALTHCARE-LAKE CHARLES, LLC
Active
Other names
At Home Compassionate Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT EUGENE JETER M.B.A. (MEMBER/MANAGER)
(337) 477-7083
Entity
Organization
Contact information
Practice address
122 ARLINGTON DR, LAKE CHARLES, LA 70605
(337) 477-7083
(337) 478-4414
Mailing address
122 ARLINGTON DR, LAKE CHARLES, LA 70605-5702
(337) 477-7083
(337) 478-4414
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009075
—
LA
05
—
1014591
—
LA
Enumeration date
04/07/2016
Last updated
08/10/2018
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