Provider Demographics
NPI:1811438773
Name:WHISPERING OAKS LODGE- PINHOOK
Entity type:Organization
Organization Name:WHISPERING OAKS LODGE- PINHOOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:318-366-8596
Mailing Address - Street 1:2020 W PINHOOK RD STE 401
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3212
Mailing Address - Country:US
Mailing Address - Phone:337-735-4490
Mailing Address - Fax:877-419-0358
Practice Address - Street 1:2020 W PINHOOK RD STE 401
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3212
Practice Address - Country:US
Practice Address - Phone:337-735-4490
Practice Address - Fax:877-419-0358
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHISPERING OAKS LODGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility