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NPI Code Detail

MEDICARE: TANGI PINES NURSING CENTER LLC

MEDICARE: TANGI PINES NURSING CENTER LLC
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 Facility834LA

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 : 1740277003
Entity Type Code : Organization
Provider Name (Legal Business Name) : TANGI PINES NURSING CENTER LLC
Provider Business Mailing Address
First Line : 200 W UNIVERSITY AVE
Second Line :
City : HAMMOND
State : LA
Zip : 70401-1319
Country : US
Telephone Number : 985-429-8800
Fax Number : 985-542-0912
Provider Business Practice Location Address
First Line : 709 E NORTH PL
Second Line :
City : AMITE
State : LA
Zip : 70422-2307
Country : US
Telephone Number : 985-748-9464
Fax Number : 985-748-4404
Authorized Official
Title or Position : COO/MEMBER
Name : MR. DANIEL J LABORDE
Credential :
Telephone Number : 985-429-8800
Provider Enumeration Date : 10/03/2005
Last Update Date : 06/16/2008

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Directions to “TANGI PINES NURSING CENTER LLC ” Practice Location

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