| Washington-marion Sbhc | |
|
2802 Pineview St Lake Charles LA 70615-2063 | |
| (337) 217-4540 | |
| (337) 439-5029 |
| Full Name | Washington-marion Sbhc |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 2802 Pineview St, Lake Charles, Louisiana |
| Authorized Official Name and Position | Paul Trevino (CEO) |
| Authorized Official Contact | 3374917730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Washington-marion Sbhc 524 Dr Michael Debakey Dr Lake Charles LA 70601-5725 Ph: (337) 217-4540 | Washington-marion Sbhc 2802 Pineview St Lake Charles LA 70615-2063 Ph: (337) 217-4540 |
| NPI Number | 1043472202 |
|---|---|
| Provider Enumeration Date | 06/30/2008 |
| Last Update Date | 07/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043472202 | NPI | - | NPPES |
| 1447153 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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