Healthcare Provider Details

I. General information

NPI: 1942352828
Provider Name (Legal Business Name): MAISON ORLEANS I, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 MEHLE ST
ARABI LA
70032-1444
US

IV. Provider business mailing address

343 3RD ST SUITE 600
BATON ROUGE LA
70801-1309
US

V. Phone/Fax

Practice location:
  • Phone: 225-343-9152
  • Fax: 225-343-9154
Mailing address:
  • Phone: 225-343-9152
  • Fax: 225-343-9154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number196
License Number StateLA

VIII. Authorized Official

Name: MR. BOB G. DEAN JR.
Title or Position: MANAGING MEMBER
Credential:
Phone: 225-343-9152