# WINNSBORO OPCO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LEGACY NURSING AND REHABILITATION OF WINNSBORO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275180655
- **Authorized official:** VICTOR DEVIN GUM (MANAGER)
- **Authorized official phone:** (225) 800-4954

## Contact information

- **Practice address:** 804 POLK ST, WINNSBORO, LA 71295-2350
- **Practice address phone:** (318) 435-6116
- **Practice address fax:** (318) 435-3993
- **Mailing address:** 8675 BLUEBONNET BLVD STE A, BATON ROUGE, LA 70810-2976
- **Mailing address phone:** (225) 800-4954

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 08/21/2019
- **Last updated:** 08/23/2019