Provider Demographics
NPI:1205875648
Name:ST FRANCES PFU LLC
Entity type:Organization
Organization Name:ST FRANCES PFU LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BROUSSARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-639-2934
Mailing Address - Street 1:417 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:OBERLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70655-3519
Mailing Address - Country:US
Mailing Address - Phone:337-639-2934
Mailing Address - Fax:337-639-4373
Practice Address - Street 1:417 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:LA
Practice Address - Zip Code:70655-3519
Practice Address - Country:US
Practice Address - Phone:337-639-2934
Practice Address - Fax:337-639-4373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA734314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1517054Medicaid
LA195499Medicare Oscar/Certification
LA195499Medicare ID - Type UnspecifiedPROVIDER NUMBER