MEDICARE: SCLANDA TEZENO

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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1255137071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCLANDA TEZENO

Provider Business Mailing Address
First Line	:	1562 W MAIN ST
Second Line	:
City	:	VILLE PLATTE
State	:	LA
Zip	:	70586-2824
Country	:	US
Telephone Number	:	337-831-8171
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 LOUISIANA AVE
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-4634
Country	:	US
Telephone Number	:	337-831-8171
Fax Number	:	337-363-8527

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2025
Last Update Date	:	02/21/2025

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Directions to “ SCLANDA TEZENO ” Practice Location

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