OrganizationActive
Clc of Lake Providence, LLC
NPI 1902896657 · Skilled Nursing Facility · Lake Providence, LA
Provider details
- NPI number
- 1902896657
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Douglas Wright, Managing Member(662) 680-3148
- License
- 750 (LA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
5976 Highway 65 N
Lake Providence, LA 71254-5235
Phone: (318) 559-4050
Fax: (318) 559-4052
Approximate (ZIP-level) locationGet directions
Mailing address
5976 Highway 65 N
Lake Providence, LA 71254-5235
Other names (DBA / former)
- Doing business as
- Lake Providence Subacute Rehab Center
Registry dates
- Enumerated
- 2005-10-25
- Last updated
- 2008-01-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.