Louisiana Guest House LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

922 Issued in LA

Legal business name

LOUISIANA GUEST HOUSE LLC

Practice address

418 Albertsons Parkway
Broussard, LA 70518

Phone

(337) 839-9005

NPI assigned

May 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James E Richardson

Title

Ceo

Phone

(318) 445-6470

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Camelot of Broussard Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023068335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8055",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713061055",
            "telephone_number": "318-445-6470",
            "fax_number": "318-445-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 ALBERTSONS PARKWAY",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "70518",
            "telephone_number": "337-839-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA GUEST HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-445-6470"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510670",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelot of Broussard",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Life Tree Pharmacy Services Incorporated
• Holden Linn, DC
• Amber D Littlefield, PMHNP-BC
• Jeffrey Todd Long, RPH
• Louisiana CVS Pharmacy, L.L.C.
• Louisiana Guest House, LLC
• Deedee Cantrelle Luke, MD
• Lynn M. Guidry MD
• Charles Cary Manuel, DDS
• Michel Richard Martien, CPM, LM

• Skilled Nursing Facility in Broussard, LA
• Providers in Broussard, LA by specialty
• Skilled Nursing Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.