Provider Demographics
NPI:1659497048
Name:PLANTATION MANAGEMENT COMPANY, LLC
Entity Type:Organization
Organization Name:PLANTATION MANAGEMENT COMPANY, LLC
Other - Org Name:PLANTATION MANAGEMENT COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:W
Authorized Official - Last Name:DELATTE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:225-664-6697
Mailing Address - Street 1:301 VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-4722
Mailing Address - Country:US
Mailing Address - Phone:225-664-6697
Mailing Address - Fax:225-665-0510
Practice Address - Street 1:301 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-4722
Practice Address - Country:US
Practice Address - Phone:225-664-6697
Practice Address - Fax:225-665-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAH54420Medicare ID - Type UnspecifiedHOME OFFICE PROVIDER NO.