# AVOYELLES MANOR, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912922147
- **Authorized official:** MR. PHILIP PEPITON (ADMINISTRATOR)
- **Authorized official phone:** (318) 922-3404

## Contact information

- **Practice address:** 5682 HWY 107 SOUTH, DUPONT, LA 71329
- **Practice address phone:** (318) 922-3404
- **Practice address fax:** (318) 922-3680
- **Mailing address:** 5682 HIGHWAY 107, DUPONT, LA 71329
- **Mailing address phone:** (318) 922-3404
- **Mailing address fax:** (318) 922-3680

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 240 | LA | Yes |

## Other

- **Enumeration date:** 07/12/2006
- **Last updated:** 03/16/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1514951 | — | LA |
| 01 | — | 190031190Z | PROVIDER NUMBER | LA |