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NPI Code Detail

MEDICARE: CONSOLATA HOME

MEDICARE: CONSOLATA HOME
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1313M00000XNursing Facility/Intermediate Care Facility147LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073568531
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONSOLATA HOME
Provider Business Mailing Address
First Line : 2319 EAST MAIN STREET
Second Line :
City : NEW IBERIA
State : LA
Zip : 70560
Country : US
Telephone Number : 337-365-8226
Fax Number : 337-365-8626
Provider Business Practice Location Address
First Line : 2319 E MAIN ST
Second Line :
City : NEW IBERIA
State : LA
Zip : 70560-4031
Country : US
Telephone Number : 337-365-8226
Fax Number : 337-365-8626
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. DAVID LANDRY
Credential :
Telephone Number : 337-365-8226
Provider Enumeration Date : 05/23/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1265404909 — DR. RICHARD ANDREW VANBERGEN M.D.
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1114978855 — DEEB SUDD MD
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1841245834 — DR. PHILLIP J SCURRIA JR. MD
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1811942808 — DR. BOYD D SNELLGROVE MD
Practice Location Address:
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Practice Fax: 337-367-0131
1083661003 — RADIOLOGY ASSOCIATES OF IBERIA
Practice Location Address:
2315 E MAIN ST
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1205873858 — LOUISIANA EM-1 MEDICAL SERVICES, PA
Practice Location Address:
2315 E MAIN ST
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Directions to “CONSOLATA HOME ” Practice Location

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