Healthcare Provider Details

I. General information

NPI: 1932253549
Provider Name (Legal Business Name): ST FRANCISVILLE COUNTRY MANOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15243 LA HIGHWAY 10
SAINT FRANCISVILLE LA
70775-4752
US

IV. Provider business mailing address

15243 LA HIGHWAY 10
SAINT FRANCISVILLE LA
70775-4752
US

V. Phone/Fax

Practice location:
  • Phone: 225-635-3346
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number735
License Number StateLA

VIII. Authorized Official

Name: MR. FRANK T STEWART JR.
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 225-635-3346