Provider Demographics
NPI:1245229806
Name:RIVER WEST, L.P.
Entity Type:Organization
Organization Name:RIVER WEST, L.P.
Other - Org Name:RIVER WEST HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-687-0820
Mailing Address - Street 1:58604 BELLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-3915
Mailing Address - Country:US
Mailing Address - Phone:225-687-0820
Mailing Address - Fax:225-687-1920
Practice Address - Street 1:58604 BELLEVIEW DR
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-3915
Practice Address - Country:US
Practice Address - Phone:225-687-0820
Practice Address - Fax:225-687-1920
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVER WEST, L.P.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-17
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA883251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1401811Medicaid
LA1401811Medicaid