NPIMap

Organization Active NPI

Harbor Hospice of Lake Charles, LP

  • Community Based Hospice Care Agency
  • Lake Charles, LA
National Provider Identifier
1093823890
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
19-1625 Issued in LA
Legal business name
HARBOR HOSPICE OF LAKE CHARLES, LP
Practice address
5210 Lake St
Lake Charles, LA 70605-6574
Phone
(337) 562-8620
Fax
(337) 562-8621
NPI assigned
Aug 29, 2006
Last updated
Apr 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Karen Carter
Title
Exec Admin Asst
Phone
(409) 730-2046

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 185 LA
Community Based Hospice Care Agency 251G00000X 19-1625 LA Primary

Addresses

Primary practice location

5210 Lake St
Lake Charles, LA 70605-6574

Mailing address

3406 College St
Suite 200
Beaumont, TX 77701-4612
Phone (409) 813-2332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060403000095 LA Part A Provider - Hospice 3072521020 Practice locations: Lake Charles, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093823890. Details of each certification follow.

Hospice certification: CCN 191625

Legal name
HARBOR HOSPICE OF LAKE CHARLES, LP
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 14, 2006
Last certification
Mar 6, 2020
Ownership / control type
Proprietary - Partnership
Organization structure
PartnershipProprietary
Incorporated
Feb 2, 2006 in TX
Enrollment address
5210 Lake Street
Lake Charles, LA 70605

Care Compare: Hospice

Medicare Care Compare
Listed as
Harbor Hospice of Lake Charles, LPCCN 191625 · All quality measures
Ownership
For-Profit
Certified
Jun 14, 2006
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1055642Harbor Hospice of Lake Charles LP5210 Lake Street, Lake Charles, LA 70605Certificate of waiverJun 3, 2028

National Provider Directory

National Provider Directory

Locations

2501 E Prien Lake Rd
Lake Charles, LA 70601
Phone (337) 660-5343

2750 Aster St
Ste 155
Lake Charles, LA 70601

5210 Lake St
Lake Charles, LA 70605
Phone (337) 562-8620

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mohammad S Sarwar Individual 5% Or Greater Direct Ownership Interest Oct 1, 2006
General Partnership Interest Oct 1, 2006
Karen Carter Individual W-2 Managing Employee Feb 1, 2019
Mir Khan Individual 5% Or Greater Direct Ownership Interest Oct 1, 2006
General Partnership Interest Oct 1, 2006
HHCS Managers LLC Organization, Beaumont, TX LLC 5% Or Greater Direct Ownership Interest Oct 1, 2006
General Partnership Interest Oct 1, 2006
Carlos M Choucino Individual 5% Or Greater Direct Ownership Interest Oct 1, 2006
General Partnership Interest Oct 1, 2006
Qamar U Arfeen Individual 5% Or Greater Direct Ownership Interest Feb 16, 2006
General Partnership Interest Apr 3, 2006
W-2 Managing Employee Feb 16, 2006

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Carlos M Choucino, MD
    • Infectious Disease Physician
    • Lake Charles, LA
    • NPI 1386604338

    5% Or Greater Direct Ownership Interest, General Partnership Interest

    CMS ownership
  • Mir Akbar Khan, MD
    • Internal Medicine Physician
    • Lake Charles, LA
    • NPI 1669448080

    5% Or Greater Direct Ownership Interest, General Partnership Interest

    CMS ownership
  • Mohammed S. Sarwar, M.D.
    • Internal Medicine Physician
    • Lake Charles, LA
    • NPI 1407823644

    5% Or Greater Direct Ownership Interest, General Partnership Interest

    CMS ownership
  • Qamar U Arfeen, M.D.
    • Pulmonary Disease Physician
    • Beaumont, TX
    • NPI 1295738649

    5% Or Greater Direct Ownership Interest, General Partnership Interest, W-2 Managing Employee

    CMS ownership

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1093823890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 COLLEGE ST",
            "address_2": "SUITE 200",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014612",
            "telephone_number": "409-813-2332",
            "fax_number": "409-232-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5210 LAKE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706056574",
            "telephone_number": "337-562-8620",
            "fax_number": "337-562-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HOSPICE OF LAKE CHARLES, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "EXEC ADMIN ASST",
        "authorized_official_telephone_number": "409-730-2046"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": "185",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": "19-1625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.