NPIMap

Organization Active NPI

Southwest Louisiana Hospital Association Inc

Doing business as Home Health Agency of Lake Charles Memorial Hospital

  • Home Health Agency
  • Lake Charles, LA
National Provider Identifier
1649295015
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
3 Issued in LA
Legal business name
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC
Doing business as
Home Health Agency of Lake Charles Memorial Hospital
Practice address
2010 Oak Park Blvd
Lake Charles, LA 70601-8913
Phone
(337) 494-6444
Fax
(337) 494-6451
NPI assigned
Jul 13, 2006
Last updated
Dec 4, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Dawn Johnson-Hatcher
Title
Cfo
Phone
(337) 494-2094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 3 LA Primary

Addresses

Primary practice location

2010 Oak Park Blvd
Lake Charles, LA 70601-8913

Mailing address

1701 Oak Park Blvd
Lake Charles, LA 70601-8911
Phone (337) 494-6444

Other names 1

  • Home Health Agency of Lake Charles Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070815000593 LA Part A Provider - Home Health Agency 3274427695 Practice locations: Lake Charles, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649295015. Details of each certification follow.

Home health agency certification: CCN 197005

Legal name
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC
Doing business as
HOME HEALTH AGENCY OF LAKE CHARLES MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 27, 1972
Last certification
May 5, 2021
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Enrollment address
2010 Oak Park Blvd
Lake Charles, LA 70601-7828

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
HH Agency of Lake Charles MemoCCN 197005 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Dec 27, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy

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
19D0461790Home HLTH Agency of Lake Charles Memorial Hospital2010 Oak Park Boulevard, Lake Charles, LA 70601Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
William G Hebert16 organizations share this tax ID, including this one
Part of
William G Hebert

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Joseph Miller Individual Corporate Officer Jan 1, 2011
Neil Aspinwall Individual Corporate OfficerBoard Member Jan 1, 2018
Amanda E Ellington Individual Corporate OfficerBoard Member Jan 1, 2022
Mitchell Adrian Individual Corporate OfficerBoard Member Jan 1, 2017
Southwest Louisiana Hospital Association Inc Organization, Lake Charles, LA Non-profit 5% Or Greater Direct Ownership Interest Feb 7, 1973 100%
Benjamin Martin Azevedo Individual Corporate OfficerBoard Member Jan 1, 2023
Joseph Gregory Lugo Individual Other Jan 1, 2021
Edward Carl Bergen Individual Corporate OfficerBoard Member Jan 1, 2022
William R Condos Individual Corporate OfficerBoard Member Jan 1, 2017
Ulysses Thibodeaux Individual Corporate Officer Jan 1, 2011
Denise E Rau Individual Corporate Officer Jan 1, 2011
Steven Gillespie Individual Corporate DirectorDirector of Finance Feb 19, 2026
W-2 Managing EmployeeDirector of Finance Feb 19, 2026
Operational/Managerial ControlDirector of Finance Feb 19, 2026
James Devon Hyde Individual Corporate OfficerCeo Apr 12, 2021
Louis Todd Individual Corporate Officer Jan 1, 2011
Daniel T Hall Individual Corporate OfficerBoard Member Jan 1, 2021

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lake Charles Memorial HospitalLake Charles, LA, CCN 19T060 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Lake Charles Memorial HospitalLake Charles, LA, CCN 19S060 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Iowa Health CenterIowa, LA, CCN 193408 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Jun 1, 2010

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1649295015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018911",
            "telephone_number": "337-494-6444",
            "fax_number": "337-494-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018913",
            "telephone_number": "337-494-6444",
            "fax_number": "337-494-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION",
        "enumeration_date": "2006-07-13",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON-HATCHER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "337-494-2094"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "LA",
            "license": "3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Health Agency of Lake Charles Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Home Health Agency of Lake Charles Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.