Organization
JACKSON MANOR 1691 TENANT, LLC
Active
Other names
Jackson Manor Nursing & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX PALEY (COO)
(914) 390-4363
Entity
Organization
Contact information
Practice address
1691 S HUDSON AVE, JONESBORO, LA 71251-5856
(318) 259-7386
(318) 259-4644
Mailing address
1691 S HUDSON AVE, JONESBORO, LA 71251-5856
(318) 259-7386
(318) 259-4644
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
865
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510726
—
LA
Enumeration date
07/18/2005
Last updated
02/12/2008
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