Provider Demographics
NPI:1962457358
Name:DEPARTMENT OF HEALTH AND HOSPITALS
Entity Type:Organization
Organization Name:DEPARTMENT OF HEALTH AND HOSPITALS
Other - Org Name:LAKE CHARLES BEHAVIORAL HEALTH CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:KARIMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:337-475-8022
Mailing Address - Street 1:4105 KIRKMAN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-4603
Mailing Address - Country:US
Mailing Address - Phone:337-475-8022
Mailing Address - Fax:337-475-8054
Practice Address - Street 1:4105 KIRKMAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-4603
Practice Address - Country:US
Practice Address - Phone:337-475-8022
Practice Address - Fax:337-475-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA283261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder