Organization
BAKER WELLNESS CENTER ADHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODOLFO M MANALAC M.D. (OWNER/PRESIDENT)
(225) 778-1567
Entity
Organization
Contact information
Practice address
2402 MAIN STREET, BAKER, LA 70714
(225) 778-1567
(225) 771-1520
Mailing address
P.O. BOX 668, BAKER, LA 70704
(225) 778-1567
(225) 771-1520
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
2020
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1643360
—
LA
Enumeration date
10/02/2006
Last updated
08/22/2020
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