Healthcare Provider Details

I. General information

NPI: 1326732660
Provider Name (Legal Business Name): 7435 BR SNF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7435 BISHOP OTT DR
BATON ROUGE LA
70806-8930
US

IV. Provider business mailing address

2100 VEROT SCHOOL RD STE 4
LAFAYETTE LA
70508-6466
US

V. Phone/Fax

Practice location:
  • Phone: 225-939-6766
  • Fax:
Mailing address:
  • Phone: 337-270-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: CHARLES A. MOODY
Title or Position: AUTHORIZED AGENT
Credential:
Phone: 337-270-9090