Organization
CARROLL NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA C REARDON (ADMINISTRATOR)
(318) 428-3249
Entity
Organization
Contact information
Practice address
307 N. CASTLEMAN ST, OAK GROVE, LA 71263
(318) 428-3249
Mailing address
PO BOX 788, OAK GROVE, LA 71263-0788
(318) 428-3249
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
165
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511595
—
LA
01
—
34848
BLUE CROSS
LA
Enumeration date
01/09/2006
Last updated
12/22/2016
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