Provider Demographics
NPI:1467657304
Name:NORTHEAST LOUISANA VETERANS HOME
Entity Type:Organization
Organization Name:NORTHEAST LOUISANA VETERANS HOME
Other - Org Name:NE LA WAR VETERANS HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:AO
Authorized Official - Phone:318-362-4206
Mailing Address - Street 1:6700 HIGHWAY 165 N
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-8753
Mailing Address - Country:US
Mailing Address - Phone:318-362-4206
Mailing Address - Fax:318-362-4241
Practice Address - Street 1:6700 HIGHWAY 165 N
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-8753
Practice Address - Country:US
Practice Address - Phone:318-362-4206
Practice Address - Fax:318-362-4241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility