# VIRGINIA HALL NURSING HOME

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Progressive Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730124488
- **Authorized official:** MR. RICHARD EUGENE BOYTER N.F.A. (ADMINISTRATOR)
- **Authorized official phone:** (318) 212-6461

## Contact information

- **Practice address:** 2715 ALBERT L BICKNELL DR, SHREVEPORT, LA 71103-3925
- **Practice address phone:** (318) 212-8200
- **Practice address fax:** (318) 212-8220
- **Mailing address:** 2715 ALBERT L BICKNELL DR, SHREVEPORT, LA 71103-3925
- **Mailing address phone:** (318) 212-8200
- **Mailing address fax:** (318) 212-8220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 284 | LA | Yes |
| 332BN1400X | Nursing Facility Supplies (DME) | — | LA | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | LA | — |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 12/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1516597 | — | LA |