Provider Demographics
NPI:1952392821
Name:TWIN OAKS NURSING HOME, INC.
Entity Type:Organization
Organization Name:TWIN OAKS NURSING HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARY LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-626-1900
Mailing Address - Street 1:506 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-3940
Mailing Address - Country:US
Mailing Address - Phone:985-652-9538
Mailing Address - Fax:985-652-8949
Practice Address - Street 1:506 W 5TH ST
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3940
Practice Address - Country:US
Practice Address - Phone:985-652-9538
Practice Address - Fax:985-652-8949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA322314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1513849Medicaid
LA51384Medicaid
LA1513849Medicaid