MEDICARE: ST LUKE HOUSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1366309395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST LUKE HOUSE

Provider Business Mailing Address
First Line	:	619 ADELIA LN
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-8706
Country	:	US
Telephone Number	:	225-907-5264
Fax Number	:

Provider Business Practice Location Address
First Line	:	7439 BISHOP OTT DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-8930
Country	:	US
Telephone Number	:	225-907-5264
Fax Number	:

Authorized Official
Title or Position	:	CONSULTANT
Name	:	TIFFANY STEPHENS
Credential	:
Telephone Number	:	225-573-4255

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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Directions to “ST LUKE HOUSE ” Practice Location

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