| NPI | 1376004796 |
|---|---|
| Doing Business As | SHREVEPORT MANOR SKILLED NURSING AND REHABILITATION |
| Entity Type | Organization |
| Authorized Contact | STEVEN BOULWARE Managing Member 972-428-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2019-03-28 |