Healthcare Provider Details

I. General information

NPI: 1740446848
Provider Name (Legal Business Name): MEADOWCREST NURSING AND REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 07/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 COMMERCE ST
GRETNA LA
70056-7316
US

IV. Provider business mailing address

535 COMMERCE ST
GRETNA LA
70056-7316
US

V. Phone/Fax

Practice location:
  • Phone: 504-393-9595
  • Fax: 504-392-8899
Mailing address:
  • Phone: 504-393-9595
  • Fax: 504-392-8899

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: MR. ROBERT BATES
Title or Position: OWNER
Credential:
Phone: 940-464-7010