Provider Demographics
NPI:1881292357
Name:SAVOY MEDICAL MANAGEMENT GROUP, INC.
Entity type:Organization
Organization Name:SAVOY MEDICAL MANAGEMENT GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARMENTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-468-0350
Mailing Address - Street 1:801 POINCIANA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MAMOU
Mailing Address - State:LA
Mailing Address - Zip Code:70554-2243
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 POINCIANA AVE STE 200
Practice Address - Street 2:
Practice Address - City:MAMOU
Practice Address - State:LA
Practice Address - Zip Code:70554-2243
Practice Address - Country:US
Practice Address - Phone:337-468-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAVOY MEDICAL MANAGEMENT GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-15
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2203785109OtherSTATE LICENSE