Healthcare Provider Details

I. General information

NPI: 1982177820
Provider Name (Legal Business Name): PLANTATION MANAGEMENT COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7119 HIGHWAY 1
MANSURA LA
71350
US

IV. Provider business mailing address

301 VETERANS BLVD
DENHAM SPRINGS LA
70726-4722
US

V. Phone/Fax

Practice location:
  • Phone: 318-253-6553
  • Fax: 318-253-4946
Mailing address:
  • Phone: 225-664-6697
  • Fax: 225-665-0510

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: SCOTT HOLDEN QUIRK
Title or Position: MANAGING MEMBER
Credential:
Phone: 225-664-6697