| NPI | 1609865096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE MCPHERSON Owner 337-981-2258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: LA 688) |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies (Licence: LA 688) |
| 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: LA 688) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2012-03-20 |