Lake Charles Senior Care Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LAKE CHARLES SENIOR CARE CLINIC LLC

Practice address

1909 Southwood Dr
Lake Charles, LA 70605-4132

Phone

(337) 532-5799

NPI assigned

Nov 9, 2022

Last updated

Nov 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jenny Bono

Title

Manager

Phone

(337) 532-5799

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1821706805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 SOUTHWOOD DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 SOUTHWOOD DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054132",
            "telephone_number": "337-532-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CHARLES SENIOR CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "BONO",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "337-532-5799"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Charles Medical Services, Inc (Charles B. Woodard, M.D., Cardiovascular Diseases)
• Lake Charles Memorial Heart and Vascular Center (Heart & Vascular Center)
• Lake Charles Pharmaceutical Supply Company LLC (Medical Plaza Pharmacy)
• Lake Charles Primary Care and Wellness
• Lake Charles Rheumatology LLC
• Lake Charles Sports & Rehab
• Lake Charles Urgent Care
• Lake Charles Urgent Care
• Lake Physical Therapy, LLC
• Lake Wellness Center, LLC

• Primary Care Clinic/Center in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Primary Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.