Woodlake Addiction Recovery of Mississippi, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

WOODLAKE ADDICTION RECOVERY OF MISSISSIPPI, LLC

Practice address

152 Gateway Dr
Biloxi, MS 39531-4409

Phone

(225) 924-1910

NPI assigned

Sep 1, 2020

Organization subpart

Yes

Parent organization

WOODLAKE MANAGEMENT, LLCAs reported in NPPES

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

Authorized official

Name

Kendall McCullar

Title

Credentialing Specialist

Phone

(225) 900-8940

Specialties & licenses 1

Addresses

Part of

Woodlake Management LLC

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1376157032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41853",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708351853",
            "telephone_number": "225-900-8940",
            "fax_number": "855-532-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 GATEWAY DR",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395314409",
            "telephone_number": "225-924-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAKE ADDICTION RECOVERY OF MISSISSIPPI, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOODLAKE MANAGEMENT, LLC",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "MCCULLAR",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "225-900-8940"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emmalee Winston
• Brenda M Wise, RPH
• Francine Mary Wolpe, MD
• Catherine Leigh Wood, DPT
• Jami S Woodham, M.S,R.D.,L.D.
• Kelly Demetrius Woods, PHD
• Woolmarket Pharmacy, Inc.
• Christine Johns Wright, NP
• Kay-Ann Wright
• Tamatha Lynn Wright, ILCSW

• Substance Abuse Rehabilitation Facility in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Substance Abuse Rehabilitation Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.