Healthcare Provider Details

I. General information

NPI: 1811934391
Provider Name (Legal Business Name): RIO SOL NURSING HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7049 ZELYNNE ST
MANSURA LA
71350-4637
US

IV. Provider business mailing address

7049 ZELYNNE ST
MANSURA LA
71350-4637
US

V. Phone/Fax

Practice location:
  • Phone: 318-964-2198
  • Fax: 318-964-2190
Mailing address:
  • Phone: 318-964-2198
  • Fax: 318-964-2190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number167
License Number StateLA

VIII. Authorized Official

Name: MS. LAURA SPRUILL
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 318-964-2198