Healthcare Provider Details

I. General information

NPI: 1902378698
Provider Name (Legal Business Name): STM VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 04/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1539 DELACHAISE ST
NEW ORLEANS LA
70115-3513
US

IV. Provider business mailing address

3525 BIENVILLE ST
NEW ORLEANS LA
70119-5249
US

V. Phone/Fax

Practice location:
  • Phone: 504-895-3953
  • Fax: 504-896-1010
Mailing address:
  • Phone: 504-279-6414
  • Fax: 504-277-1834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. LAWRENCE E. STANSBERRY III
Title or Position: CEO
Credential:
Phone: 504-279-6414