# MERRYVILLE NURSING CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376697664
- **Authorized official:** MR. GARY MIZE (ADMINISTRATOR)
- **Authorized official phone:** (337) 825-6181

## Contact information

- **Practice address:** 900 N BRYAN ST, MERRYVILLE, LA 70653-3302
- **Practice address phone:** (337) 825-6181
- **Practice address fax:** (337) 825-2007
- **Mailing address:** 900 N BRYAN ST, P.O. BOX 820, MERRYVILLE, LA 70653-3302
- **Mailing address phone:** (337) 825-6181
- **Mailing address fax:** (337) 825-2007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 881 | LA | Yes |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 02/02/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1510025 | — | LA |