Organization
AVALON PLACE, LP
Active
Other names
Avalon Place
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAWNE R SMITH (CEO)
(318) 812-2140
Entity
Organization
Contact information
Practice address
4385 OLD STERLINGTON RD, MONROE, LA 71203-2360
(318) 322-2000
(318) 812-2143
Mailing address
4385 OLD STERLINGTON RD, MONROE, LA 71203-2360
(318) 322-2000
(318) 812-2143
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
435
LA
332BN1400X
Nursing Facility Supplies (DME)
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1521094
—
LA
01
—
3965490001
PALMETTO GBA DMERC
LA
Enumeration date
08/05/2006
Last updated
02/14/2014
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