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Organization
THE GLEN RETIREMENT SYSTEM
Active
Organization
THE GLEN RETIREMENT SYSTEM
Active
Other names
Village Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA D. WILLIAMS (CHIEF FINANCIAL OFFICER)
(318) 798-3500
Entity
Organization
Contact information
Practice address
403 E FLOURNOY LUCAS RD, SHREVEPORT, LA 71115-3906
(318) 798-3500
(318) 798-7988
Mailing address
403 E FLOURNOY LUCAS RD, SHREVEPORT, LA 71115-3906
(318) 798-3500
(318) 798-7988
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
449
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1516864
—
LA
Enumeration date
10/17/2006
Last updated
08/22/2020
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