Provider Demographics
NPI:1619277290
Name:ALLIED HEALTHCARE LLC
Entity Type:Organization
Organization Name:ALLIED HEALTHCARE LLC
Other - Org Name:LAKESHORE COMMUNITY HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.O.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-445-6470
Mailing Address - Street 1:4333 SHREVEPORT HWY
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-3828
Mailing Address - Country:US
Mailing Address - Phone:318-445-6470
Mailing Address - Fax:318-641-6282
Practice Address - Street 1:1495 GARDENA DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-1913
Practice Address - Country:US
Practice Address - Phone:504-284-5933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1670315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities