# BOSSIER HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heritage Manor of Bossier
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639126873
- **Authorized official:** KENNETH USSERY (VP)
- **Authorized official phone:** (407) 571-1550

## Contact information

- **Practice address:** 2575 AIRLINE DR, BOSSIER CITY, LA 71111-5812
- **Practice address phone:** (318) 746-7466
- **Practice address fax:** (318) 747-0014
- **Mailing address:** 2575 AIRLINE DR, BOSSIER CITY, LA 71111-5812
- **Mailing address phone:** (318) 746-7466
- **Mailing address fax:** (318) 747-0014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 877 | LA | Yes |

## Other

- **Enumeration date:** 05/30/2006
- **Last updated:** 11/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1510823 | — | LA |