# MAISON TECHE, LLC

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

## Provider details

- **NPI number:** 1922051796
- **Authorized official:** BRENDA TARVER (MANAGER)
- **Authorized official phone:** (318) 445-4346

## Contact information

- **Practice address:** 7307 E OLD SPANISH TRL, JEANERETTE, LA 70544-6100
- **Practice address phone:** (337) 276-4514
- **Practice address fax:** (318) 473-4360
- **Mailing address:** 2230 S MACARTHUR DR, ALEXANDRIA, LA 71301-3057
- **Mailing address phone:** (318) 445-4346
- **Mailing address fax:** (318) 473-4360

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 464 | LA | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 08/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1518395 | — | LA |