Baker Wellness Center Adhc

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

2020 Issued in LA

Legal business name

BAKER WELLNESS CENTER ADHC

Practice address

2402 Main Street
Baker, LA 70714

Phone

(225) 778-1567

Fax

(225) 771-1520

NPI assigned

Oct 2, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Rodolfo M Manalac, M.D.

Title

Owner/President

Phone

(225) 778-1567

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114010667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 668",
            "city": "BAKER",
            "state": "LA",
            "postal_code": "70704",
            "telephone_number": "225-778-1567",
            "fax_number": "225-771-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 MAIN STREET",
            "city": "BAKER",
            "state": "LA",
            "postal_code": "70714",
            "telephone_number": "225-778-1567",
            "fax_number": "225-771-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAKER WELLNESS CENTER ADHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANALAC",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "225-778-1567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "LA",
            "license": "2020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1643360",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Baker Community Mental Health Center,LLC
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• Baker Medical Corporation, LTD
• Baker Physical Therapy Clinic
• Baker School Based Health Clinic
• Mallory Bankston, APRN, FNP-C
• Jeremy Beauchamp
• Maisha Lashawn Beauchamp
• Cicella Lorine Benton, BACHELORS DEGREE
• Ashley Michelle Biagas

• Custodial Care Facility in Baker, LA
• Providers in Baker, LA by specialty
• Custodial Care Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.