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Organization
PELICAN HEALTHCARE INC
Active
Organization
PELICAN HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETHA A HAYNES (OWNER)
(985) 652-4136
Entity
Organization
Contact information
Practice address
948 CAMBRIDGE DR STE 102, LA PLACE, LA 70068-3647
(985) 652-7717
(985) 652-4137
Mailing address
948 CAMBRIDGE DR STE 102, LA PLACE, LA 70068-3647
(985) 652-7717
(985) 618-3611
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138910
MEDICARE
LA
05
—
884314700
—
LA
Enumeration date
08/30/2006
Last updated
04/21/2023
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