NPI | 1053648774 |
---|---|
Doing Business As | WOODLAKE ADDICTION RECOVERY CENTER |
Entity Type | Organization |
Authorized Contact | RANDAL ANTHONY GOMEZ Managing Member 225-683-4144 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: LA 156) |
Enumeration Date | 2009-11-17 |
Last Update Date | 2009-11-17 |