Healthcare Provider Details

I. General information

NPI: 1851569636
Provider Name (Legal Business Name): DEERFIELD NURSING & REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 02/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 MAIN ST
DELHI LA
71232-2538
US

IV. Provider business mailing address

522 MAIN ST
DELHI LA
71232-2538
US

V. Phone/Fax

Practice location:
  • Phone: 318-878-2417
  • Fax: 318-878-8408
Mailing address:
  • Phone: 318-878-2417
  • Fax: 318-878-8408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number948
License Number StateLA

VIII. Authorized Official

Name: DELBERT T WILBANKS
Title or Position: MANAGING MEMBER
Credential:
Phone: 318-628-4116