Provider Demographics
NPI:1013231547
Name:OUR LADY OF THE LAKE ADVANCED HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:OUR LADY OF THE LAKE ADVANCED HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-765-6898
Mailing Address - Street 1:8415 GOODWOOD BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-7851
Mailing Address - Country:US
Mailing Address - Phone:225-765-5727
Mailing Address - Fax:225-765-9244
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 612
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-769-5656
Practice Address - Fax:225-766-6996
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OUR LADY OF THE LAKE HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty