1871688309 NPI number — THE WOODLANDS HEALTHCARE CENTER, L.L.C.

Table of content: (NPI 1871688309)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871688309 NPI number — THE WOODLANDS HEALTHCARE CENTER, L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE WOODLANDS HEALTHCARE CENTER, L.L.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871688309
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
144 THAD BILLS DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEESVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71446-2832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-239-6578
Provider Business Mailing Address Fax Number:
337-238-2723

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
144 THAD BAILS ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEESVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-239-6578
Provider Business Practice Location Address Fax Number:
337-238-2723
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TITMAN
Authorized Official First Name:
RACHAEL
Authorized Official Middle Name:
MICHELLE
Authorized Official Title or Position:
DIRECTOR OF REVENUE CYCLE
Authorized Official Telephone Number:
972-428-0876

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  883 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1510891 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com