Provider Demographics
NPI:1811934391
Name:RIO SOL NURSING HOME INC
Entity type:Organization
Organization Name:RIO SOL NURSING HOME INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRUILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-964-2198
Mailing Address - Street 1:7049 ZELYNNE ST
Mailing Address - Street 2:
Mailing Address - City:MANSURA
Mailing Address - State:LA
Mailing Address - Zip Code:71350-4637
Mailing Address - Country:US
Mailing Address - Phone:318-964-2198
Mailing Address - Fax:318-964-2190
Practice Address - Street 1:7049 ZELYNNE ST
Practice Address - Street 2:
Practice Address - City:MANSURA
Practice Address - State:LA
Practice Address - Zip Code:71350-4637
Practice Address - Country:US
Practice Address - Phone:318-964-2198
Practice Address - Fax:318-964-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA167314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1511994Medicaid
LA1511994Medicaid