LAKE WELLNESS CENTER, LLC (NPI# 1790242436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790242436 |
| Entity Type | Organization |
| Organization Name | LAKE WELLNESS CENTER, LLC |
| Practice Address |
19411 Helenbirg Rd Ste 101 Covington LA 70433-5199 |
| Mailing Address |
501 W Saint Mary Blvd Ste 308 Lafayette LA 70506-4600 |
| Practice Telephone | 9856025253 |
| Practice Fax Number | 9853172323 |
| 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 |
|---|---|---|---|---|
| 1518424258 | Lake Wellness Center, LLC | Substance Abuse Rehabilitation Facility | 4330 Loveland St Ste A, Metairie, LA 70006-4179 | 2019-03-01 |
| 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 |
| 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 |
19411 HELENBIRG RD STE 101 |
| City | COVINGTON |
| State | LA |
| Zip Code | 70433-5199 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952556094 | Chad W Trosclair | Family Medicine | 19411 Helenbirg Rd Ste 101, Covington, LA 70433-5199 | 2008-11-17 |
| 1699308296 | David Andrew Kelly | Counselor | 19411 Helenbirg Rd Ste 101, Covington, LA 70433-5199 | 2020-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790301018 | Caroline K. Wilson | Speech-Language Pathologist | 19105 Sandy Lane Suite A, Covington, LA 70433 | 2020-06-23 |
| 1568092013 | Tracy T Aljabi | Nurse Practitioner | 648 Crestwood Dr., Covington, LA 70433 | 2020-01-23 |
| 1093365462 | Maria Robert Hebrock | Marriage & Family Therapist | 71338 La-21, Suite 101, Covington, LA 70433 | 2019-09-17 |
| 1750930806 | Terry Fink Troxler | Speech-Language Pathologist | 521 Covington Point Dr, Covington, LA 70433 | 2019-09-10 |
| 1780231589 | Margaret Nordness Favre | Behavioral Analyst | 3999 Us-190, Covington, LA 70433 | 2019-08-26 |
| 1881241180 | Jennifer Ann Bacile | Counselor | 604 E 15th Street, Covington, LA 70433 | 2019-08-21 |
| 1356906689 | Moving and Caring Transportation LLC | Non-emergency Medical Transport (VAN) | 251 Vintage Drive, Covington, LA 70433 | 2019-05-02 |
| 1780153874 | Nga Endoscopy Center LLC | Clinic/Center | 7015 Hwy 190 E Service Road Suite 103, Covington, LA 70433 | 2018-11-19 |
| 1831667229 | Geauxprodme | Durable Medical Equipment & Medical Supplies | 1304 Champagne Street, Covington, LA 70433 | 2018-11-05 |
| 1376037994 | Pamela Ann Bernabo | Specialist/Technologist, Other | 80 Maison Drive, Covington, LA 70433 | 2018-06-18 |
| Find all providers in zip 70433 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1437196946 | Department of Health and Hospitals | Clinic/Center | 19404 N 10th St, Covington, LA 70433-8892 | 2006-06-01 |
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| 1518055367 | Alleghany Highlands Community Services | Clinic/Center | 311 S Monroe Ave, Covington, VA 24426-1635 | 2006-10-10 |
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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 |
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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.