Healthcare Provider Details

I. General information

NPI: 1790714871
Provider Name (Legal Business Name): WOODS HAVEN NURSING CARE & REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8275 HWY 165
POLLOCK LA
71467
US

IV. Provider business mailing address

PO BOX 159
POLLOCK LA
71467-0159
US

V. Phone/Fax

Practice location:
  • Phone: 318-765-3557
  • Fax: 318-765-9862
Mailing address:
  • Phone: 318-765-3557
  • Fax: 318-765-9862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number376
License Number StateLA

VIII. Authorized Official

Name: DEBBIE NUGENT
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-765-3557