MEDICARE: WHISPERING OAKS LODGE- PINHOOK

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	:	1811438773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHISPERING OAKS LODGE- PINHOOK

Provider Business Mailing Address
First Line	:	2020 W PINHOOK RD STE 401
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-3212
Country	:	US
Telephone Number	:	337-735-4490
Fax Number	:	877-419-0358

Provider Business Practice Location Address
First Line	:	2020 W PINHOOK RD STE 401
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-3212
Country	:	US
Telephone Number	:	337-735-4490
Fax Number	:	877-419-0358

Authorized Official
Title or Position	:	CEO
Name	:	DARREN DAVIS
Credential	:	R. PH.
Telephone Number	:	318-366-8596

Provider Enumeration Date	:	03/13/2017
Last Update Date	:	03/13/2017

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Directions to “WHISPERING OAKS LODGE- PINHOOK ” Practice Location

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