Provider Demographics
NPI:1376582791
Name:STT CORPORATION
Entity Type:Organization
Organization Name:STT CORPORATION
Other - Org Name:GUEST HOUSE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DELATTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-664-6697
Mailing Address - Street 1:11188 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-2012
Mailing Address - Country:US
Mailing Address - Phone:225-275-7570
Mailing Address - Fax:225-272-2311
Practice Address - Street 1:10145 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-1718
Practice Address - Country:US
Practice Address - Phone:225-272-0111
Practice Address - Fax:225-275-3437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA222314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1516911Medicaid
LA195537Medicare ID - Type UnspecifiedPROVIDER NUMBER