Healthcare Provider Details

I. General information

NPI: 1982641395
Provider Name (Legal Business Name): PLANTATION MANAGEMENT COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

839 N RANGE AVE
DENHAM SPRINGS LA
70726-2937
US

IV. Provider business mailing address

301 VETERANS BLVD
DENHAM SPRINGS LA
70726-4722
US

V. Phone/Fax

Practice location:
  • Phone: 225-665-8946
  • Fax:
Mailing address:
  • Phone: 225-665-8946
  • Fax: 225-667-1066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number146
License Number StateLA

VIII. Authorized Official

Name: MS. KIM DELATTE
Title or Position: COMPTROLLER
Credential:
Phone: 225-664-6697