Organization
MER ROUGE COMMUNITY SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA MICHELLE REYNOLDS (BILLING BOOKKEEPING)
(318) 647-3691
Entity
Organization
Contact information
Practice address
1400 DAVENPORT AVE, MER ROUGE, LA 71261-0263
(318) 647-3691
(318) 647-3743
Mailing address
PO BOX 263, MER ROUGE, LA 71261-0263
(318) 647-3691
(318) 647-3743
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1557871
—
LA
Enumeration date
07/02/2008
Last updated
09/23/2008
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