Healthcare Provider Details

I. General information

NPI: 1952392821
Provider Name (Legal Business Name): TWIN OAKS NURSING HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 01/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 W 5TH ST
LA PLACE LA
70068-3940
US

IV. Provider business mailing address

506 W 5TH ST
LA PLACE LA
70068-3940
US

V. Phone/Fax

Practice location:
  • Phone: 985-652-9538
  • Fax: 985-652-8949
Mailing address:
  • Phone: 985-652-9538
  • Fax: 985-652-8949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number322
License Number StateLA

VIII. Authorized Official

Name: MARY LYNN LEACH
Title or Position: CFO
Credential:
Phone: 985-626-1900