Organization
IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY
Active
Other names
ImCal BH Lake Charles, Imperial Calcasieu HSA Behavioral Health Lake Charles
Organization subpart
No
Provider details
NPI number
Authorized official
NIKYIA BROWN (CREDENTIALING SPEC.)
(337) 475-3100
Entity
Organization
Contact information
Practice address
4105 KIRKMAN ST, LAKE CHARLES, LA 70607-4603
(337) 475-8022
(337) 475-8054
Mailing address
4105 KIRKMAN ST, LAKE CHARLES, LA 70607-4603
(337) 475-8022
(337) 475-8054
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
95
LA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
95
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710041
—
LA
Enumeration date
02/01/2007
Last updated
11/10/2025
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