Organization
PONTCHARTRAIN GUEST HOUSE INC
Active
Other names
PONTCHARTRAIN HEALTH CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARY LYNN LEACH (CHIEF FINANCIAL OFFICER)
(985) 626-1900
Entity
Organization
Contact information
Practice address
1401 FLORIDA ST, MANDEVILLE, LA 70448-5433
(985) 626-8581
(985) 624-9478
Mailing address
PO BOX 338, MANDEVILLE, LA 70470-0338
(985) 626-1900
(985) 727-9660
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
312
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1513784
—
LA
Enumeration date
08/24/2006
Last updated
03/29/2012
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