Organization
LOUISIANA GUEST HOUSE LLC
Active
Other names
Camelot of Broussard
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES E RICHARDSON (CEO)
(318) 445-6470
Entity
Organization
Contact information
Practice address
418 ALBERTSONS PARKWAY, BROUSSARD, LA 70518
(337) 839-9005
Mailing address
PO BOX 8055, ALEXANDRIA, LA 71306-1055
(318) 445-6470
(318) 445-6422
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
922
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510670
—
LA
Enumeration date
05/10/2006
Last updated
08/22/2020
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