Organization
D'VILLE HOME GROUP, LLC
Active
Other names
Chateau D'Ville Rehab and Retirement
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN D BOULWARE (AUTHORIZED REPRESENTATIVE)
(985) 855-4424
Entity
Organization
Contact information
Practice address
401 VATICAN DR, DONALDSONVILLE, LA 70346-4017
(225) 473-8614
(225) 473-4331
Mailing address
401 VATICAN DR, DONALDSONVILLE, LA 70346-4017
(225) 473-8614
(225) 473-4331
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1016
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1520187
—
LA
01
—
34811
BC/BS
LA
Enumeration date
05/02/2006
Last updated
07/31/2012
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