Organization
CONVENIENT CARE LLC
Active
Other names
Lake After Hours Brusly
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE P SELLARS (PRESIDENT)
(225) 214-9353
Entity
Organization
Contact information
Practice address
4463 HWY 1 SOUTH, BRUSLY, LA 70767-0000
(225) 771-8012
(225) 771-8017
Mailing address
PO BOX 679632, DALLAS, TX 75267-9632
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1441376
—
LA
01
—
CJ4680
MEDICAID RR
LA
Enumeration date
08/11/2010
Last updated
01/24/2023
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