| Hilary Peace Rd Llc | |
|
215 W Prien Lake Rd Lake Charles LA 70601-8450 | |
| (936) 332-8334 | |
| (337) 201-9883 |
| Full Name | Hilary Peace Rd Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 215 W Prien Lake Rd, Lake Charles, Louisiana |
| Authorized Official Name and Position | Hilary Leggio (REGISTERED DIETITIAN) |
| Authorized Official Contact | 9363328334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hilary Peace Rd Llc 215 W Prien Lake Rd Lake Charles LA 70601-8450 Ph: (936) 332-8334 | Hilary Peace Rd Llc 215 W Prien Lake Rd Lake Charles LA 70601-8450 Ph: (936) 332-8334 |
| NPI Number | 1770187023 |
|---|---|
| Provider Enumeration Date | 11/27/2020 |
| Last Update Date | 09/06/2023 |
| Medicare PECOS PAC ID | 3173935954 |
|---|---|
| Medicare Enrollment ID | O20210127001085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770187023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Primary |
| Provider Name | Hilary P Leggio |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1104304567 PECOS PAC ID: 8123377330 Enrollment ID: I20200730002870 |
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