| NPI | 1164678405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MOUTON MCCOY Business Office Manager 337-237-3940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: LA 936) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |