Organization
MAISON TECHE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA TARVER (MANAGER)
(318) 445-4346
Entity
Organization
Contact information
Practice address
7307 E OLD SPANISH TRL, JEANERETTE, LA 70544-6100
(337) 276-4514
(318) 473-4360
Mailing address
2230 S MACARTHUR DR, ALEXANDRIA, LA 71301-3057
(318) 445-4346
(318) 473-4360
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
464
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518395
—
LA
Enumeration date
05/19/2006
Last updated
08/20/2008
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