Provider Demographics
NPI:1982743456
Name:SPIRITAS SENIOR SERVICES
Entity Type:Organization
Organization Name:SPIRITAS SENIOR SERVICES
Other - Org Name:ST. JAMES PLACE OF BATON ROUGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VICE PRESIDENT/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MELANCON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-215-4603
Mailing Address - Street 1:333 LEE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4980
Mailing Address - Country:US
Mailing Address - Phone:225-215-4500
Mailing Address - Fax:225-215-4601
Practice Address - Street 1:333 LEE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4980
Practice Address - Country:US
Practice Address - Phone:225-215-4500
Practice Address - Fax:225-215-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA384314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA195410Medicare ID - Type Unspecified