{"npi":"1164989802","type":"NPI-2","status":"active","name":{"display":"Lake Wellness Center, LLC","other":[],"organization_name":"LAKE WELLNESS CENTER, LLC","authorised_official":"George Roussel"},"specialty":{"primary_taxonomy":"261QR0405X","primary_taxonomy_description":"Substance Use Disorder Rehabilitation Clinic/Center","slug":"substance-use-disorder-rehabilitation-clinic-center","schema_org_specialty":null,"all":[{"code":"324500000X","description":"Substance Abuse Rehabilitation Facility","primary":false,"state":null,"license":null},{"code":"261QR0405X","description":"Substance Use Disorder Rehabilitation Clinic/Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"3620 CHESTNUT ST","city":"NEW ORLEANS","state":"LA","postal_code":"701153615","country_code":"US","phone":"5056765253","fax":"5046765151"},{"purpose":"MAILING","street_1":"PO BOX 53038","city":"LAFAYETTE","state":"LA","postal_code":"705053038","country_code":"US","phone":"3377813408"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2019-03-01","last_updated":"2025-11-14","_meta":{"source":"NPPES","snapshot_date":"2025-11-14","doc_url":"https://findmynpi.com/api"}}