# ST MICHAEL PFU LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** THE CARE CENTER OF DEQUINCY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639118078
- **Authorized official:** SCOTT BROUSSARD (CPA)
- **Authorized official phone:** (337) 639-2934

## Contact information

- **Practice address:** 602 N DIVISION ST, DEQUINCY, LA 70633-3129
- **Practice address phone:** (337) 786-2466
- **Practice address fax:** (337) 786-6266
- **Mailing address:** PO BOX 1219, DEQUINCY, LA 70633-1219
- **Mailing address phone:** (337) 786-2466
- **Mailing address fax:** (337) 786-6266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 857 | LA | Yes |

## Other

- **Enumeration date:** 06/04/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1510661 | — | LA |