Healthcare Provider Details

I. General information

NPI: 1831284686
Provider Name (Legal Business Name): COLETTE'S NURSING & HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 VETERANS MEMORIAL BLVD STE 7
KENNER LA
70062-4104
US

IV. Provider business mailing address

1117 VETERANS MEMORIAL BLVD STE 7
KENNER LA
70062-4104
US

V. Phone/Fax

Practice location:
  • Phone: 504-305-6130
  • Fax: 504-305-2377
Mailing address:
  • Phone: 504-305-6130
  • Fax: 504-305-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number12313
License Number StateLA

VIII. Authorized Official

Name: MS. COLETTE BENNETT
Title or Position: ADMINISTRATOR
Credential: LPN
Phone: 504-305-6130