# PONTCHARTRAIN GUEST HOUSE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PONTCHARTRAIN HEALTH CARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598872640
- **Authorized official:** MR. MARY LYNN LEACH (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (985) 626-1900

## Contact information

- **Practice address:** 1401 FLORIDA ST, MANDEVILLE, LA 70448-5433
- **Practice address phone:** (985) 626-8581
- **Practice address fax:** (985) 624-9478
- **Mailing address:** PO BOX 338, MANDEVILLE, LA 70470-0338
- **Mailing address phone:** (985) 626-1900
- **Mailing address fax:** (985) 727-9660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 312 | LA | Yes |

## Other

- **Enumeration date:** 08/24/2006
- **Last updated:** 03/29/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1513784 | — | LA |