Provider Demographics
NPI:1013014141
Name:METAIRIE OPERATIONS, LLC
Entity Type:Organization
Organization Name:METAIRIE OPERATIONS, LLC
Other - Org Name:METAIRIE HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-626-1900
Mailing Address - Street 1:2045 HIGHWAY 59
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-1909
Mailing Address - Country:US
Mailing Address - Phone:985-626-1900
Mailing Address - Fax:985-727-9660
Practice Address - Street 1:6401 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-3206
Practice Address - Country:US
Practice Address - Phone:504-885-8611
Practice Address - Fax:504-887-3581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA854314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1510629Medicaid
LA195278Medicare Oscar/Certification