Provider Demographics
NPI:1497988380
Name:OPELOUSAS HEALTHCARE PROPERTIES LLC
Entity Type:Organization
Organization Name:OPELOUSAS HEALTHCARE PROPERTIES LLC
Other - Org Name:HERITAGE MANOR OF OPELOUSAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:H
Authorized Official - Last Name:PARKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-708-1408
Mailing Address - Street 1:7941 I-49 S SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-9003
Mailing Address - Country:US
Mailing Address - Phone:337-942-7588
Mailing Address - Fax:
Practice Address - Street 1:7941 I-49 S SERVICE RD
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-9003
Practice Address - Country:US
Practice Address - Phone:337-942-7588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1520276Medicaid