LAKE WELLNESS CENTER, LLC (NPI# 1518424258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518424258 |
| Entity Type | Organization |
| Organization Name | LAKE WELLNESS CENTER, LLC |
| Practice Address |
4330 Loveland St Ste A Metairie LA 70006-4179 |
| Mailing Address |
501 W Saint Mary Blvd Ste 308 Lafayette LA 70506-4600 |
| Practice Telephone | 5047365253 |
| Practice Fax Number | 5046765252 |
| Mailing Telephone | 3377813408 |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2019-03-01 |
| Authorized Official Name | GEORGE ROUSSEL (OWNER) |
| Authorized Official Telephone | 3377030880 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346707080 | Lake Wellness Center, LLC | Substance Abuse Rehabilitation Facility | 7434 Picardy Ave Ste A&b, Baton Rouge, LA 70808-7204 | 2019-03-01 |
| 1528525268 | Lake Wellness Center, LLC | Substance Abuse Rehabilitation Facility | 4540 Ambassador Caffery Pkwy Ste C110, Lafayette, LA 70508-6937 | 2019-03-01 |
| 1740824507 | Lake Wellness Center, LLC | Clinic/Center | 13100 River Rd, Destrehan, LA 70047-5219 | 2019-11-04 |
| 1790242436 | Lake Wellness Center, LLC | Substance Abuse Rehabilitation Facility | 19411 Helenbirg Rd Ste 101, Covington, LA 70433-5199 | 2019-03-01 |
| 1164989802 | Lake Wellness Center, LLC | Substance Abuse Rehabilitation Facility | 3620 Chestnut St, New Orleans, LA 70115-3615 | 2019-03-01 |
| 1982161626 | Lake Wellness Center, LLC | Substance Abuse Rehabilitation Facility | 1340 W Tunnel Blvd Ste 212, Houma, LA 70360-2818 | 2019-03-01 |
| 1255898995 | Lake Wellness Center, LLC | Substance Abuse Rehabilitation Facility | 635a Petro Point Dr, Lake Charles, LA 70607-7054 | 2019-03-01 |
| Street Address |
4330 LOVELAND ST STE A |
| City | METAIRIE |
| State | LA |
| Zip Code | 70006-4179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437786365 | Christina Alder Humble | Behavior Technician | 4201 N 1-10 Service Road W., Metairie, LA 70006 | 2020-03-23 |
| 1285270959 | Brittanie Renee Tank | Behavior Technician | 4201 N 1-10 Service Rd, W, Metairie, LA 70006 | 2019-11-18 |
| 1447896105 | Jacob Dent Dds Dentists of Metairie A Professional Corporation | Dentist | 5201 Veterans Memorial Blvd., Suite A, Metairie, LA 70006 | 2019-11-18 |
| 1417504861 | Caryn Tesia Washington | Behavior Technician | 4201 N 1-10 Service Rd W., Metarie, LA 70006 | 2019-08-21 |
| 1568023356 | Brittany Nicole Davis | Behavioral Analyst | 4201 N-i 10 Service Rd, Metairie, LA 70006 | 2019-06-24 |
| 1295393650 | Beth Ann Martin | Behavior Technician | 4201 N. Service Road W, Metairie, LA 70006 | 2019-05-31 |
| 1942866561 | Manunique Johnson | Behavior Technician | 4201 N-1-10 Service Rd W., Metairie, LA 70006 | 2019-05-20 |
| 1972068419 | Stacey R Phipps | Behavior Technician | 4201 N 1-10 Service Rd. W., Metairie, LA 70006 | 2019-02-08 |
| 1740752799 | Na'triana Clark | Behavior Technician | 4210 N I-10 Service Rd, Metairie, LA 70006 | 2018-12-31 |
| 1861969131 | Lauren Hay Hughes | Behavior Technician | 4201 N 1-10 Service Rd. West, Metairie, LA 70006 | 2018-10-25 |
| Find all providers in zip 70006 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1679043905 | Applegate Health Services, Inc | Clinic/Center | 2000 Audubon Ave Ste C, Thibodaux, LA 70301-5075 | 2018-11-29 |
| 1003394776 | Applegate Health Services, Inc | Clinic/Center | 4451 Bluebonnet Blvd Ste E, Baton Rouge, LA 70809-9647 | 2018-08-03 |
| 1811440209 | House of Jacob Health Services | Clinic/Center | 316 Filmore St, Kenner, LA 70062-7810 | 2016-08-02 |
| 1427419951 | Council On Alcohol and Drug Abuse for Greater New Orleans | Clinic/Center | 2640 Canal St Fl 4, New Orleans, LA 70119-6410 | 2016-03-11 |
| 1184001448 | Silkworth Treatment Services | Clinic/Center | 5319 Didesse Dr, Suite D, Baton Rouge, LA 70808-6401 | 2015-05-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.