Organization
OLLIE STEELE BURDEN MANOR, INC
Active
Other names
St. Clare Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD J. SMITH (PRESIDENT)
(225) 216-3604
Entity
Organization
Contact information
Practice address
7435 BISHOP OTT DRIVE, BATON ROUGE, LA 70806-8930
(225) 216-3604
(225) 216-3746
Mailing address
7435 BISHOP OTT DRIVE, BATON ROUGE, LA 70806-8930
(225) 216-3604
(225) 216-3746
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
718
LA
314000000X
Skilled Nursing Facility
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1520969
—
LA
Enumeration date
07/19/2005
Last updated
04/21/2009
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