# JEFFERSON MANOR NURSING & REHAB CNTR LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jefferson Manor Nursing & Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306827449
- **Authorized official:** MR. TEDDY RAY PRICE (MANAGING MEMBER)
- **Authorized official phone:** (318) 628-4116

## Contact information

- **Practice address:** 9919 JEFFERSON HWY, BATON ROUGE, LA 70809-2769
- **Practice address phone:** (225) 293-1434
- **Practice address fax:** (225) 291-3254
- **Mailing address:** 9919 JEFFERSON HWY, BATON ROUGE, LA 70809-2769
- **Mailing address phone:** (225) 293-1434
- **Mailing address fax:** (225) 291-3254

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 751 | LA | Yes |

## Other

- **Enumeration date:** 11/07/2005
- **Last updated:** 09/12/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1521213 | — | LA |