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Contact Information

SOUTHWEST LOUISIANA INDEPENDENCE CENTER INC.
4320 LAKE ST.
LAKE CHARLES, LA70605
 Phone: 337-477-7194
 Fax: 337-477-7198
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

In Home Supportive Care

253Z00000X
 

Case Management

251B00000X
Indicates primary specialty

NPI Profile & details for SOUTHWEST LOUISIANA INDEPENDENCE CENTER INC.

NPI Number 1588790919
LBN Legal business name SOUTHWEST LOUISIANA INDEPENDENCE CENTER INC.
Authorized official RANDY DARTEZ - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/27/2007
Last updated 09/06/2023 - About 3 years ago
Identifiers
LA License # 11089
LA Medicaid 1196045
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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