Organization
ST MICHAEL PFU LLC
Active
Other names
THE CARE CENTER OF DEQUINCY
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT BROUSSARD (CPA)
(337) 639-2934
Entity
Organization
Contact information
Practice address
602 N DIVISION ST, DEQUINCY, LA 70633-3129
(337) 786-2466
(337) 786-6266
Mailing address
PO BOX 1219, DEQUINCY, LA 70633-1219
(337) 786-2466
(337) 786-6266
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
857
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510661
—
LA
Enumeration date
06/04/2006
Last updated
08/22/2020
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