Provider Demographics
NPI:1275514457
Name:BELLE TECHE NURSING & REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:BELLE TECHE NURSING & REHABILITATION CENTER, LLC
Other - Org Name:BELLE TECHE NURSING & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:TEDDY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-628-4116
Mailing Address - Street 1:PO BOX 9766
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70562-9766
Mailing Address - Country:US
Mailing Address - Phone:318-364-5472
Mailing Address - Fax:337-365-8932
Practice Address - Street 1:1306 W ADMIRAL DOYLE DR
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-8552
Practice Address - Country:US
Practice Address - Phone:318-364-5472
Practice Address - Fax:337-365-8932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA314314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1520730Medicaid
LA195460Medicare Oscar/Certification