Provider Demographics
NPI:1295733202
Name:TOWN & COUNTRY NURSING CENTER,LLC
Entity type:Organization
Organization Name:TOWN & COUNTRY NURSING CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-377-5148
Mailing Address - Street 1:614 WESTON ST
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3660
Mailing Address - Country:US
Mailing Address - Phone:318-377-5148
Mailing Address - Fax:318-377-2973
Practice Address - Street 1:614 WESTON ST
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3660
Practice Address - Country:US
Practice Address - Phone:318-377-5148
Practice Address - Fax:318-377-2973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA703314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1513873Medicaid
LA1513873Medicaid