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NPI Code Detail

MEDICARE: MANOR ESTATES INC

MEDICARE: MANOR ESTATES INC
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
1314000000XSkilled Nursing Facility5019NM

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 : 1124049044
Entity Type Code : Organization
Provider Name (Legal Business Name) : MANOR ESTATES INC
Provider Business Mailing Address
First Line : 105 N TRENTON ST
Second Line :
City : RUSTON
State : LA
Zip : 71270-4321
Country : US
Telephone Number : 318-255-1514
Fax Number : 318-255-1517
Provider Business Practice Location Address
First Line : 500 LOUISIANA BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-2051
Country : US
Telephone Number : 505-255-1717
Fax Number : 505-255-5188
Authorized Official
Title or Position : GENERAL PARTNER
Name : MR. DANNY N MILAM
Credential :
Telephone Number : 318-255-1514
Provider Enumeration Date : 07/23/2006
Last Update Date : 11/21/2007

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Directions to “MANOR ESTATES INC ” Practice Location

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