Healthcare Provider Details

I. General information

NPI: 1184612871
Provider Name (Legal Business Name): VERMILION HEALTH CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 02/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14008 CHENEAU RD
KAPLAN LA
70548-6565
US

IV. Provider business mailing address

14008 CHENEAU RD
KAPLAN LA
70548-6565
US

V. Phone/Fax

Practice location:
  • Phone: 337-643-1949
  • Fax: 337-643-2898
Mailing address:
  • Phone: 337-643-1949
  • Fax: 337-643-2898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number386
License Number StateLA

VIII. Authorized Official

Name: TERESA PAULA WALTERS
Title or Position: ADMINISTRATOR
Credential:
Phone: 337-643-1949