Organization
VERSAILLES HEALTHCARE LLC
Active
Other names
Matthews Memorial Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID W STALLARD (MANAGER REPRESENTATIVE)
(601) 956-8884
Entity
Organization
Contact information
Practice address
5100 JACKSON STREET EXT, ALEXANDRIA, LA 71303-2317
(318) 445-5215
(318) 442-8067
Mailing address
5100 JACKSON STREET EXT, ALEXANDRIA, LA 71303-2317
(318) 445-5215
(318) 442-8067
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1514624
—
LA
01
—
385H00000X
RESPITE CARE
LA
Enumeration date
09/15/2009
Last updated
01/29/2014
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