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General NPI Number Information
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NPI Number | 1992786396
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Entity Type | Organization
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Legal Business Name | CHRISTWOOD
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 06/02/2011
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Provider Practice Location Address
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Address Line | 100 CHRISTWOOD BLVD
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City | COVINGTON
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State | LA
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Zip | 70433-4606
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Country | US
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Telephone | 985-898-0515
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Fax | 985-898-0529
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Provider Business Mailing Address
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Address Line | 100 CHRISTWOOD BLVD
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City | COVINGTON
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State | LA
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Zip | 70433-4606
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Country | US
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Telephone | 985-898-0515
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Fax | 985-898-0529
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. DAVID M COOK
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Credential |
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Telephone | 985-898-0515
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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 | 690
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License Number State | LA
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