Organization
PRIORITY GROUP HOLDINGS, L.L.C.
Active
Other names
Jo Ellen Smith Convalescent Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS B BOULWARE (MANAGER)
(318) 658-9978
Entity
Organization
Contact information
Practice address
4502 GENERAL MEYER AVE, NEW ORLEANS, LA 70131-3531
(504) 361-7923
(504) 368-4807
Mailing address
4502 GENERAL MEYER AVE, NEW ORLEANS, LA 70131-3531
(504) 361-7923
(504) 368-4807
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2203782578
DHH LICENSE
LA
Enumeration date
10/29/2015
Last updated
01/02/2016
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