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Organization
PMG OPCO-GUEST HOUSE LLC
Active
Organization
PMG OPCO-GUEST HOUSE LLC
Active
Other names
THE GUEST HOUSE SKILLED NURSING AND REHABILITATION
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN BOULWARE (MANAGING MEMBER)
(972) 428-0900
Entity
Organization
Contact information
Practice address
9225 NORMANDIE DR, SHREVEPORT, LA 71118-3249
(318) 686-0515
(318) 687-0311
Mailing address
9225 NORMANDIE DR, SHREVEPORT, LA 71118-3249
(318) 686-0515
(318) 687-0311
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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