Organization
AVOYELLES MANOR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP PEPITON (ADMINISTRATOR)
(318) 922-3404
Entity
Organization
Contact information
Practice address
5682 HWY 107 SOUTH, DUPONT, LA 71329
(318) 922-3404
(318) 922-3680
Mailing address
5682 HIGHWAY 107, DUPONT, LA 71329
(318) 922-3404
(318) 922-3680
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
240
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1514951
—
LA
01
—
190031190Z
PROVIDER NUMBER
LA
Enumeration date
07/12/2006
Last updated
03/16/2011
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