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General NPI Number Information
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NPI Number | 1598723769
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Entity Type | Organization
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Legal Business Name | PLAQUEMINE CARING, LLC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 59215 RIVER WEST DR
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City | PLAQUEMINE
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State | LA
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Zip | 70764-6552
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Country | US
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Telephone | 225-687-0240
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Fax | 225-687-0249
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Provider Business Mailing Address
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Address Line | 59215 RIVER WEST DR
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City | PLAQUEMINE
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State | LA
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Zip | 70764-6552
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Country | US
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Telephone | 225-687-0240
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Fax | 225-687-0249
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Authorized Official
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Title or Position | MANAGER
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Name | MR. VICTOR D. GUM
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Credential |
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Telephone | 225-800-4955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 441
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License Number State | LA
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