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General NPI Number Information
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NPI Number | 1669055828
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Entity Type | Organization
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Legal Business Name | TASS COVINGTON, LLC
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Dates
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Enumeration Date | 05/04/2021
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 5 S DIVISION DR
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City | COVINGTON
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State | LA
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Zip | 70433-1107
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Country | US
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Telephone | 504-669-5979
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Fax |
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Provider Business Mailing Address
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Address Line | 5 S DIVISION DR
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City | COVINGTON
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State | LA
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Zip | 70433-1107
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Country | US
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Telephone | 504-669-5979
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUZANNE LENTZ
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Credential | MCD, CCC-SLP
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Telephone | 504-669-5979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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