Provider Demographics
NPI:1114184405
Name:NURSING SOLUTIONS OF LA LL C
Entity Type:Organization
Organization Name:NURSING SOLUTIONS OF LA LL C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-644-7613
Mailing Address - Street 1:214 S BURNSIDE AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-3453
Mailing Address - Country:US
Mailing Address - Phone:225-644-7613
Mailing Address - Fax:225-644-2338
Practice Address - Street 1:214 S BURNSIDE AVE STE 203
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-3453
Practice Address - Country:US
Practice Address - Phone:225-644-7613
Practice Address - Fax:225-644-2338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15021305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1042960Medicaid