Provider Demographics
NPI:1649853417
Name:DISASTER CHARITIES INC
Entity type:Organization
Organization Name:DISASTER CHARITIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ETCH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-310-3809
Mailing Address - Street 1:PO BOX 4238
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70606-4238
Mailing Address - Country:US
Mailing Address - Phone:757-310-3809
Mailing Address - Fax:
Practice Address - Street 1:5855 E BROOKE FLOWER CIR STE A
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-0299
Practice Address - Country:US
Practice Address - Phone:757-310-3809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No251K00000XAgenciesPublic Health or Welfare
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service