Organization
LAGNIAPPE HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES GOODWIN GLADNEY JR. (MANAGING PARTNER)
(318) 281-0078
Entity
Organization
Contact information
Practice address
1408 SUMMERLIN LN, BASTROP, LA 71220-2529
(318) 281-5188
Mailing address
1523 TEXAS AVE, BASTROP, LA 71220-4043
(318) 281-0078
(318) 281-2753
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
291
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1513229
—
LA
Enumeration date
08/11/2008
Last updated
08/11/2008
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