Organization
OUR LADY OF THE LAKE HOSPITAL, INC.
Active
Other names
Our Lady of the Lake Regional Medical Center Skilled Nursing Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT D. DAVIDGE (CHIEF EXECUTIVE OFFICER)
(225) 765-7702
Entity
Organization
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-6565
(225) 767-1159
Mailing address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-6565
(225) 767-1159
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/04/2005
Last updated
08/22/2020
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