Organization
PRINCETON PLACE - RUSTON, LP
Active
Other names
Princeton Place - Ruston
Organization subpart
No
Provider details
NPI number
Authorized official
DAWNE R SMITH (CEO)
(318) 812-2140
Entity
Organization
Contact information
Practice address
1405 WHITE ST, RUSTON, LA 71270-7213
(318) 812-2140
(318) 812-2143
Mailing address
1405 WHITE ST, RUSTON, LA 71270-7213
(318) 812-2140
(318) 812-2143
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
931
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1520233
—
LA
01
—
5887450001
MEDICARE DMERC #
TX
Enumeration date
06/10/2006
Last updated
02/14/2014
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