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General NPI Number Information
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NPI Number | 1861599029
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Entity Type | Organization
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Legal Business Name | WALDON OPERATIONS, LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 03/28/2012
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Provider Practice Location Address
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Address Line | 2401 IDAHO AVE
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City | KENNER
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State | LA
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Zip | 70062-5715
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Country | US
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Telephone | 504-466-0222
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Fax | 504-466-2198
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Provider Business Mailing Address
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Address Line | 2045 HIGHWAY 59
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City | MANDEVILLE
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State | LA
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Zip | 70448-1909
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Country | US
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Telephone | 985-626-1900
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Fax | 985-727-9660
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. MARY LYNN LEACH
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Credential |
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Telephone | 985-626-1900
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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 | 855
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License Number State | LA
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