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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