Organization
NORTHSHORE EXTENDED CARE HOSPITAL, LLC
Active
Other names
Northshore Extended Care Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD D. STELLY (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
64030 HIGHWAY 434 FL 2, LACOMBE, LA 70445-3405
(985) 218-4700
(985) 218-4701
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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