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General NPI Number Information
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NPI Number | 1821056136
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE CENTER OF OPELOUSAS LLC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 11/30/2024
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Provider Practice Location Address
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Address Line | 315 HARRY GUILBEAU RD
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City | OPELOUSAS
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State | LA
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Zip | 70570-6958
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Country | US
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Telephone | 337-948-4486
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Fax | 337-948-4524
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Provider Business Mailing Address
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Address Line | 315 HARRY GUILBEAU RD
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City | OPELOUSAS
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State | LA
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Zip | 70570-6958
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Country | US
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Telephone | 337-948-4486
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Fax | 337-948-4524
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | MS. TONI PARKINSON
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Credential |
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Telephone | 601-709-1408
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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 | 782
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License Number State | LA
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