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Organization
ST MICHAEL PFU LLC
Active
Organization
ST MICHAEL PFU LLC
Active
Other names
THE CARE CENTER OF DEQUINCY
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT BROUSSARD (CPA)
(337) 639-2934
Entity
Organization
Contact information
Practice address
602 N DIVISION ST, DEQUINCY, LA 70633-3129
(337) 786-2466
(337) 786-6266
Mailing address
PO BOX 1219, DEQUINCY, LA 70633-1219
(337) 786-2466
(337) 786-6266
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
857
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510661
—
LA
Enumeration date
06/04/2006
Last updated
08/22/2020
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