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General NPI Number Information
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NPI Number | 1922557750
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Entity Type | Organization
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Legal Business Name | WHISPERING OAKS LODGE LLC
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 09/21/2016
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Provider Practice Location Address
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Address Line | 617 PIAT ROAD
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City | YOUNGSVILLE
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State | LA
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Zip | 70592
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Country | US
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Telephone | 318-366-8596
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Fax | 318-757-8595
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Provider Business Mailing Address
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Address Line | PO BOX 351
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City | FERRIDAY
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State | LA
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Zip | 71334
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Country | US
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Telephone | 318-757-3274
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Fax | 318-757-8595
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Authorized Official
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Title or Position | CEO
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Name | MR. DARREN DAVIS
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Credential | R. PH.
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Telephone | 318-366-8596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | LA
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