Provider Demographics
NPI:1922888932
Name:MT. CARMEL ADULT DAY CARE
Entity Type:Organization
Organization Name:MT. CARMEL ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-254-4535
Mailing Address - Street 1:20292 HWY 90 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:JEANERETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70544-8560
Mailing Address - Country:US
Mailing Address - Phone:337-254-4535
Mailing Address - Fax:
Practice Address - Street 1:20292 HWY 90 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:JEANERETTE
Practice Address - State:LA
Practice Address - Zip Code:70544-8560
Practice Address - Country:US
Practice Address - Phone:337-254-4535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care