Organization
PRAIRIE MANOR, INC.
Active
Other names
Prairie Manor Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA BOOK (ADMINISTRATOR)
(337) 599-2031
Entity
Organization
Contact information
Practice address
1050 EDWIN ELLIOTT DR., PINE PRAIRIE, LA 70576
(337) 599-2031
(337) 599-2548
Mailing address
PO BOX 500, 1050 EDWIN ELLIOT DR., PINE PRAIRIE, LA 70576-0500
(337) 599-2031
(337) 599-2548
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
452
LA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19E379
—
LA
Enumeration date
11/22/2005
Last updated
12/10/2009
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