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General NPI Number Information
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NPI Number | 1033140926
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Entity Type | Organization
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Legal Business Name | MER ROUGE COMMUNITY SVC INC
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 10/25/2013
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Provider Practice Location Address
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Address Line | 1400 DAVENPORT AVE
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City | MER ROUGE
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State | LA
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Zip | 71261
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Country | US
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Telephone | 318-647-3691
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Fax | 318-647-3743
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Provider Business Mailing Address
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Address Line | 1400 DAVENPORT AVE
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City | MER ROUGE
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State | LA
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Zip | 71261
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Country | US
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Telephone | 318-647-3691
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Fax | 318-647-3743
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SUSAN J MUSGROVE
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Credential | NFA
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Telephone | 318-647-3691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SL0600X
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Taxonomy Name | Long-Term Care Clinical Nurse Specialist
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License Number | 227
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License Number State | LA
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