# BAYOU VISTA NURSING AND REHAB CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bayou Vista Nursing and Rehab Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518236884
- **Authorized official:** PHILIP BONNETTE PEPITON (MANAGER/MEMBER)
- **Authorized official phone:** (318) 922-3404

## Contact information

- **Practice address:** 323 EVERGREEN ST, BUNKIE, LA 71322-1307
- **Practice address phone:** (318) 346-2080
- **Practice address fax:** (318) 346-7879
- **Mailing address:** PO BOX 270, BUNKIE, LA 71322-0270
- **Mailing address phone:** (318) 346-2080
- **Mailing address fax:** (318) 346-7879

## Taxonomy

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

## Other

- **Enumeration date:** 12/15/2011
- **Last updated:** 01/18/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1511994 | — | LA |