MEDICARE: WESTBANK LIGHTHOUSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1265814891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTBANK LIGHTHOUSE

Provider Business Mailing Address
First Line	:	1712 HOLIDAY DR
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-3456
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1712 HOLIDAY DR
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-3456
Country	:	US
Telephone Number	:	504-218-5074
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SALLY STAIGER
Credential	:
Telephone Number	:	504-931-6048

Provider Enumeration Date	:	06/19/2015
Last Update Date	:	06/19/2015

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Directions to “WESTBANK LIGHTHOUSE ” Practice Location

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