MEDICARE: CPLACE OF SPRINGHILL SNF, LLC

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	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1932496445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CPLACE OF SPRINGHILL SNF, LLC

Provider Business Mailing Address
First Line	:	215 1ST ST NE
Second Line	:
City	:	SPRINGHILL
State	:	LA
Zip	:	71075-3217
Country	:	US
Telephone Number	:	318-539-3527
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 1ST ST NE
Second Line	:
City	:	SPRINGHILL
State	:	LA
Zip	:	71075-3217
Country	:	US
Telephone Number	:	318-539-3527
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MS. LYNDA S. HEBBELN
Credential	:
Telephone Number	:	727-723-3021

Provider Enumeration Date	:	07/05/2011
Last Update Date	:	07/05/2011

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