Healthcare Provider Details

I. General information

NPI: 1912115247
Provider Name (Legal Business Name): GOODWOOD MEDICAL REHAB CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8676 GOODWOOD BLVD SUITE #101
BATON ROUGE LA
70806-7914
US

IV. Provider business mailing address

8676 GOODWOOD BLVD SUITE #101
BATON ROUGE LA
70806-7914
US

V. Phone/Fax

Practice location:
  • Phone: 225-924-6115
  • Fax: 225-924-3112
Mailing address:
  • Phone: 225-924-6115
  • Fax: 225-924-3112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081H0002X
TaxonomyHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
License Number06806R
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number588
License Number StateLA

VIII. Authorized Official

Name: DR. DONALD ALLEN DREYER
Title or Position: MEMBER OF LLC
Credential: M.D.
Phone: 225-924-6115