Organization
SHANNONDALE OF ALEXANDRIA, INC.
Active
Other names
REGENCY HOUSE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL R. HATHORN (NFA)
(318) 445-8343
Entity
Organization
Contact information
Practice address
5131 MASONIC DR, ALEXANDRIA, LA 71301-3366
(318) 445-8343
(318) 445-8527
Mailing address
5131 MASONIC DR, ALEXANDRIA, LA 71301-3366
(318) 445-8343
(318) 445-8527
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
456
LA
Other
Enumeration date
08/28/2006
Last updated
12/02/2008
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