MEDICARE: WOODS HAVEN NURSING CARE AND REHABILITATION

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	314000000X	Skilled Nursing Facility	376	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790714871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODS HAVEN NURSING CARE AND REHABILITATION

Provider Business Mailing Address
First Line	:	2431 S ACADIAN THRUWAY STE 100
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-2300
Country	:	US
Telephone Number	:	225-800-4954
Fax Number	:

Provider Business Practice Location Address
First Line	:	8275 HWY 165
Second Line	:
City	:	POLLOCK
State	:	LA
Zip	:	71467
Country	:	US
Telephone Number	:	318-765-3557
Fax Number	:	318-765-9862

Authorized Official
Title or Position	:	MANAGER
Name	:	VICTOR DEVIN GUM
Credential	:
Telephone Number	:	225-800-4954

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	02/09/2026

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