Provider Demographics
NPI:1669480430
Name:UNITED MEDICAL HEALTHWEST - NEW ORLEANS, LLC
Entity Type:Organization
Organization Name:UNITED MEDICAL HEALTHWEST - NEW ORLEANS, LLC
Other - Org Name:UNITED MEDICAL HEALTHWEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:BSN MSA
Authorized Official - Phone:985-340-5998
Mailing Address - Street 1:15717 BELLE DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1439
Mailing Address - Country:US
Mailing Address - Phone:985-340-5998
Mailing Address - Fax:985-340-5911
Practice Address - Street 1:3201 WALL BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7755
Practice Address - Country:US
Practice Address - Phone:504-433-5551
Practice Address - Fax:504-433-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA458314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1700223Medicaid
LA1700223Medicaid