Healthcare Provider Details

I. General information

NPI: 1861038051
Provider Name (Legal Business Name): MORGAN CITY OPCO, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2019
Last Update Date: 11/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 JUSTA ST
MORGAN CITY LA
70380-1513
US

IV. Provider business mailing address

740 JUSTA ST
MORGAN CITY LA
70380-1513
US

V. Phone/Fax

Practice location:
  • Phone: 985-384-1723
  • Fax: 985-384-4942
Mailing address:
  • Phone: 985-384-1723
  • Fax: 985-384-4942

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: V. DEVIN GUM
Title or Position: MANAGER
Credential:
Phone: 225-800-4954