WOODLAKE ADDICTION RECOVERY OF MISSISSIPPI, LLC (NPI# 1376157032) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376157032 |
| Entity Type | Organization |
| Organization Name | WOODLAKE ADDICTION RECOVERY OF MISSISSIPPI, LLC |
| Practice Address |
152 Gateway Dr Biloxi MS 39531-4409 |
| Mailing Address |
Po Box 41853 Baton Rouge LA 70835-1853 |
| Practice Telephone | 2259241910 |
| Mailing Telephone | 2259008940 |
| Mailing Fax Number | 8555329362 |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-09-01 |
| Authorized Official Name | KENDALL MCCULLAR (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 2259008940 |
| Is Organization Subpart | Y |
| Parent Organization Name | WOODLAKE MANAGEMENT, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
152 GATEWAY DR |
| City | BILOXI |
| State | MS |
| Zip Code | 39531-4409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104908532 | James Joseph Morris | Psychiatry & Neurology | 152 Gateway Dr, Biloxi, MS 39531-4409 | 2006-10-19 |
| 1932679958 | Oceans Mississippi Medical Group LLC | Psychiatry & Neurology | 152 Gateway Dr, Biloxi, MS 39531-4409 | 2018-12-03 |
| 1356874903 | Teranika Douglas | Nurse Practitioner | 152 Gateway Dr, Biloxi, MS 39531-4409 | 2017-04-10 |
| 1528300266 | Biloxi Hma Physician Management LLC | Social Worker | 152 Gateway Dr, Biloxi, MS 39531-4409 | 2013-03-20 |
| 1174872105 | David Matthew Mitchell | Counselor | 152 Gateway Dr, Biloxi, MS 39531-4409 | 2012-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306460431 | Southern Home Care Services, Inc. | In Home Supportive Care | 1901 Pass Rd, Ste C, Biloxi, MS 39531 | 2020-06-04 |
| 1285287698 | Veronica Lynn Walker | Nurse Practitioner | 180-b Debuys Road, Biloxi, MS 39531 | 2019-07-24 |
| 1982264875 | Brittany Paitsel | Dietitian, Registered | 19289 Saint Joseph Street, Suite C, Biloxi, MS 39531 | 2019-06-13 |
| 1144792425 | Traditions Hospice of Biloxi, LLC | Hospice Care, Community Based | 243 Beauvoir Road, Suite B, Biloxi, MS 39531 | 2018-12-26 |
| 1790275956 | Gulf Coast Wellness Center Inc | Physical Medicine & Rehabilitation | 2318 Pass Rd Ste 7c, Biloxi, MS 39531 | 2018-05-14 |
| 1861929655 | John Marc Bailey | Physician Assistant | 2781 Ct Switzer Dr Ste 402, Biloxi, MS 39531 | 2017-05-11 |
| 1134574270 | Shondra Davis | Social Worker | 400 Veteran Ave, Biloxi, MS 39531 | 2016-04-26 |
| 1063872349 | Stephanie Nix Lentz | Physician Assistant | 180b Debuys Rd Ste 203, Biloxi, MS 39531 | 2016-03-01 |
| 1093121196 | Gulf Coast Outpatient Surgery Center, LLC | Clinic/Center | 2781 Ct Senior Switzer Drive, Suite 101, Biloxi, MS 39531 | 2014-07-09 |
| 1215354402 | Memorial Hospital At Gulfport | Physical Therapy Assistant | 2781 C.t. Switzer, Suite 404, Biloxi, MS 39531 | 2014-03-25 |
| Find all providers in zip 39531 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585809 | Oxford Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 616 Commerce Parkway, Oxford, MS 38655 | 2020-07-14 |
| 1861047250 | Defining Wellness Centers Inc. | Substance Abuse Rehabilitation Facility | 630 Lakeland East Dr Ste A, Flowood, MS 39232-9565 | 2019-08-03 |
| 1093284598 | Safe Harbor Recovery and Counseling LLC | Substance Abuse Rehabilitation Facility | 123 Westover Dr, Hattisburg, MS 39402-1329 | 2018-11-14 |
| 1164948196 | Extra Mile Recovery | Substance Abuse Rehabilitation Facility | 720 Oak Grove Rd, Mantachie, MS 38855-8469 | 2017-08-22 |
| 1891149738 | Stonewater Addiction Recovery Center | Substance Abuse Rehabilitation Facility | 38 County Road 362, Oxford, MS 38655-8514 | 2016-04-18 |
| 1386042471 | Recovery House, Inc. | Substance Abuse Rehabilitation Facility | 770 Golding Road, Columbus, MS 39704-2590 | 2014-12-05 |
| 1487067237 | Addiction Campuses of Mississippi, LLC | Substance Abuse Rehabilitation Facility | 7185 Swinnea Rd, Southaven, MS 38671-6003 | 2014-06-10 |
| 1518206440 | Alcohol Services Center, Inc. | Substance Abuse Rehabilitation Facility | 950 N West St, Jackson, MS 39202-2566 | 2013-02-13 |
| 1023373586 | Clever Recovery | Substance Abuse Rehabilitation Facility | 185 Foxtrail Rd, Picayune, MS 39466-9027 | 2012-07-11 |
| 1669603593 | Harbor Houses of Jackson, Inc. | Substance Abuse Rehabilitation Facility | 5354 I 55 S, Jackson, MS 39272-9119 | 2009-07-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.