Woodlake Management, Llc

NPI 1053648774 - Substance Abuse Rehabilitation Facility - 324500000X

NPI Details
NPI 1053648774
Enumeration Date 11/17/2009
Last Updated 11/17/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name RANDAL ANTHONY RANDAL
Position MANAGING MEMBER
Phone (225) 681-4144
Fax (225) 682-4142
Practice Location
3015 HIGHWAY 956
ETHEL LA, 70730-4520, US
Phone (225) 681-4144
Fax (225) 682-4142
Business Location
3015 HIGHWAY 956
ETHEL LA, 70730-4520, US
Phone (225) 681-4144
Fax (225) 682-4142
Toxanomy
Taxonomy Code 324500000X
License State Louisiana
License Number 156
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According to our database, Woodlake Management, Llc NPI is 1053648774, taxonomy code is 324500000X and license number is 156, license state is located at Louisiana. Woodlake Management, Llc physically located at 3015 Highway 956, Ethel LA, 70730-4520. NPI Number 1033115704 has the healthcare provider type.

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1053648774 NPI number is provided on an as is basis without warranty of any kind. 1053648774 is maintained by the National Plan & Provider Enumeration System. The contents of Woodlake Management, Llc are for informational purposes only.