Provider Demographics
NPI:1194034868
Name:CARSON INVESTMENTS OF LOUISIANA, INC
Entity Type:Organization
Organization Name:CARSON INVESTMENTS OF LOUISIANA, INC
Other - Org Name:NIGHTINGALE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-402-3555
Mailing Address - Street 1:1404 MAGNOLIA RDG
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-5042
Mailing Address - Country:US
Mailing Address - Phone:318-402-3555
Mailing Address - Fax:
Practice Address - Street 1:4427 YOUREE DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-3620
Practice Address - Country:US
Practice Address - Phone:318-402-3555
Practice Address - Fax:318-861-2587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based