Healthcare Provider Details

I. General information

NPI: 1265468904
Provider Name (Legal Business Name): PREFERRED LIVING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 SW RAILROAD AVE
VILLE PLATTE LA
70586-4525
US

IV. Provider business mailing address

113 SW RAILROAD AVE P O BOX 738
VILLE PLATTE LA
70586-4525
US

V. Phone/Fax

Practice location:
  • Phone: 337-363-2464
  • Fax: 337-363-2464
Mailing address:
  • Phone: 337-363-2464
  • Fax: 337-363-2464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number1718084
License Number StateLA

VIII. Authorized Official

Name: JAMES WRIGHT
Title or Position: ADMINISTRATOR
Credential:
Phone: 337-734-4043