Provider Demographics
NPI:1184612871
Name:VERMILION HEALTH CARE CENTER INC
Entity type:Organization
Organization Name:VERMILION HEALTH CARE CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:PAULA
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-643-1949
Mailing Address - Street 1:14008 CHENEAU RD
Mailing Address - Street 2:
Mailing Address - City:KAPLAN
Mailing Address - State:LA
Mailing Address - Zip Code:70548-6565
Mailing Address - Country:US
Mailing Address - Phone:337-643-1949
Mailing Address - Fax:337-643-2898
Practice Address - Street 1:14008 CHENEAU RD
Practice Address - Street 2:
Practice Address - City:KAPLAN
Practice Address - State:LA
Practice Address - Zip Code:70548-6565
Practice Address - Country:US
Practice Address - Phone:337-643-1949
Practice Address - Fax:337-643-2898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA386314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
30500OtherBCBS
LA1515663Medicaid
LA1515663Medicaid
30500OtherBCBS