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NPI Code Detail

MEDICARE: CHARLYN ENTERPRISES, LLC

MEDICARE: CHARLYN ENTERPRISES, 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 Facility893LA

General Provider Information

NPI Number : 1932196581
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARLYN ENTERPRISES, LLC
Provider Business Mailing Address
First Line : 804 POLK ST
Second Line :
City : WINNSBORO
State : LA
Zip : 71295-2350
Country : US
Telephone Number : 318-435-6116
Fax Number : 318-435-3993
Provider Business Practice Location Address
First Line : 804 POLK ST
Second Line :
City : WINNSBORO
State : LA
Zip : 71295-2350
Country : US
Telephone Number : 318-435-6116
Fax Number : 318-435-3993
Authorized Official
Title or Position : ACCOUNTANT
Name : MR. JEREMY PAUL LEDET
Credential :
Telephone Number : 318-574-5230
Provider Enumeration Date : 09/29/2005
Last Update Date : 08/22/2020

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Directions to “CHARLYN ENTERPRISES, LLC ” Practice Location

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