Organization
ST. AGNES HEALTHCARE & REHAB CENTER,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN T RAYMOND (OWNER / PRESIDENT)
(337) 332-4808
Entity
Organization
Contact information
Practice address
606 LATIOLAIS DR, BREAUX BRIDGE, LA 70517-4231
(337) 332-4808
(337) 332-2897
Mailing address
PO BOX 10, BREAUX BRIDGE, LA 70517-0010
(337) 332-4808
(337) 332-2897
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
423
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1516252
—
LA
Enumeration date
11/01/2005
Last updated
08/22/2020
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