Organization
PMG OPCO-ALPINE LLC
Active
Other names
ALPINE SKILLED NURSING AND REHABILITATION
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN BOULWARE (MANAGING MEMBER)
(972) 428-0900
Entity
Organization
Contact information
Practice address
2401 N SERVICE RD E, RUSTON, LA 71270-2342
(318) 255-6492
Mailing address
2401 N SERVICE RD E, RUSTON, LA 71270-2342
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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