Provider Demographics
NPI:1992007462
Name:DEMENTIA CARE, INC.
Entity Type:Organization
Organization Name:DEMENTIA CARE, INC.
Other - Org Name:THE GARDENS ASSISTED LIVING THE GUARDIAN HOUSE TOTAL ALZHEIMERS LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NEALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-480-1550
Mailing Address - Street 1:1401 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-5321
Mailing Address - Country:US
Mailing Address - Phone:337-480-1550
Mailing Address - Fax:337-480-1341
Practice Address - Street 1:1401 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5321
Practice Address - Country:US
Practice Address - Phone:337-480-1550
Practice Address - Fax:337-480-1341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA747314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility