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Organization
CENTER FOR INTEGRATED BEHAVIORAL HEALTH, LLC
Active
Organization
CENTER FOR INTEGRATED BEHAVIORAL HEALTH, LLC
Active
Parent organization
WOODLAKE MANAGEMENT, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WOODLAKE MANAGEMENT, LLC
Authorized official
MR. RANDAL A GOMEZ (CEO)
(225) 933-9000
Entity
Organization
Contact information
Practice address
10473 OLD HAMMOND HWY, BATON ROUGE, LA 70816-8264
(225) 924-1910
(225) 924-1988
Mailing address
10473 OLD HAMMOND HWY, BATON ROUGE, LA 70816-8264
(225) 924-1910
(225) 924-1988
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
2084P0802X
Addiction Psychiatry Physician
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/07/2017
Last updated
03/07/2017
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