Provider Demographics
NPI:1477659894
Name:CARENCRO NUSING HOME INC
Entity Type:Organization
Organization Name:CARENCRO NUSING HOME INC
Other - Org Name:EVANGELINE OAKS GUEST HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFLEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-896-9227
Mailing Address - Street 1:240 ARCENEAUX RD
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-6220
Mailing Address - Country:US
Mailing Address - Phone:337-896-9227
Mailing Address - Fax:337-896-0801
Practice Address - Street 1:240 ARCENEAUX RD
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-6220
Practice Address - Country:US
Practice Address - Phone:337-896-9227
Practice Address - Fax:337-896-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA390313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1515761Medicaid
LA195578Medicare ID - Type Unspecified