Provider Demographics
NPI:1376260448
Name:OLPSNH OPCO PFU LLC
Entity Type:Organization
Organization Name:OLPSNH OPCO PFU LLC
Other - Org Name:OUR LADY OF PROMPT SUCCOR NURSING FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-590-0007
Mailing Address - Street 1:954 E PRUDHOMME ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-8239
Mailing Address - Country:US
Mailing Address - Phone:337-948-3634
Mailing Address - Fax:
Practice Address - Street 1:954 E PRUDHOMME ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-8239
Practice Address - Country:US
Practice Address - Phone:337-948-3634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility