Provider Demographics
NPI:1073686077
Name:OAKWOOD OF ACADIANA LLC
Entity Type:Organization
Organization Name:OAKWOOD OF ACADIANA LLC
Other - Org Name:RIVER OAKS RETIREMENT MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SARVER
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:337-233-7115
Mailing Address - Street 1:2500 E SIMCOE ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-6413
Mailing Address - Country:US
Mailing Address - Phone:337-233-7115
Mailing Address - Fax:337-233-9125
Practice Address - Street 1:2500 E SIMCOE ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6413
Practice Address - Country:US
Practice Address - Phone:337-233-7115
Practice Address - Fax:337-233-9125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1510602Medicaid
34859OtherBCBS
LA34859OtherBLUECROSS
195502Medicare Oscar/Certification