Provider Demographics
NPI:1083651905
Name:PLANTATION MANAGEMENT COMPANY, LLC
Entity Type:Organization
Organization Name:PLANTATION MANAGEMENT COMPANY, LLC
Other - Org Name:THE GUEST HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:HOLDEN
Authorized Official - Last Name:QUIRK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-664-6697
Mailing Address - Street 1:301 VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-4722
Mailing Address - Country:US
Mailing Address - Phone:225-272-0111
Mailing Address - Fax:225-272-6377
Practice Address - Street 1:3888 NORTH BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3824
Practice Address - Country:US
Practice Address - Phone:225-344-3551
Practice Address - Fax:225-344-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA807314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1510173Medicaid
LA195473Medicare Oscar/Certification