Provider Demographics
NPI:1912062043
Name:IRVING PLACE ASSOCIATES, L.P.
Entity Type:Organization
Organization Name:IRVING PLACE ASSOCIATES, L.P.
Other - Org Name:HIGHLAND PLACE REHAB AND NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-992-0441
Mailing Address - Street 1:1736 IRVING PL
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4606
Mailing Address - Country:US
Mailing Address - Phone:318-221-1983
Mailing Address - Fax:
Practice Address - Street 1:1736 IRVING PL
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4606
Practice Address - Country:US
Practice Address - Phone:318-221-1983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA896314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1522104Medicaid
LA1522104Medicaid