| NPI | 1891794095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN S. FOLSE Administrator 225-926-0091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: LA 246) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: LA 246) |
| 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies (Licence: LA 246) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2008-10-28 |