Healthcare Provider Details

I. General information

NPI: 1326087396
Provider Name (Legal Business Name): PROMPT SUCCOR NURSING HOME CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

954 E PRUDHOMME ST
OPELOUSAS LA
70570-8239
US

IV. Provider business mailing address

954 E PRUDHOMME ST
OPELOUSAS LA
70570-8239
US

V. Phone/Fax

Practice location:
  • Phone: 337-948-3634
  • Fax: 337-942-8279
Mailing address:
  • Phone: 337-948-3634
  • Fax: 337-942-8279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number226
License Number StateLA

VIII. Authorized Official

Name: MICHAEL PURSER
Title or Position: ADMINISTRATOR
Credential:
Phone: 337-948-3634