Maison Deville of Houma

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

1518425 Issued in LA

Legal business name

MAISON DEVILLE OF HOUMA

Practice address

107 S Hollywood Rd
Houma, LA 70360-2714

Phone

(985) 876-3250

Fax

(985) 873-0046

NPI assigned

Feb 23, 2016

Organization subpart

No

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

Authorized official

Name

Tanya Hebert

Title

Assistant Administrator

Phone

(985) 876-3250

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1215396999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S HOLLYWOOD RD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703602714",
            "telephone_number": "985-876-3250",
            "fax_number": "985-873-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S HOLLYWOOD RD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703602714",
            "telephone_number": "985-876-3250",
            "fax_number": "985-873-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAISON DEVILLE OF HOUMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "985-876-3250"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "LA",
            "license": "1518425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518425",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Magnolia Drugs LLC
• Azunna Maidoh, PHARMD
• Gregory Chukwuemeka Maidoh, M.D.
• Allison Maiocchi
• Maison de'Ville Nursing Home, Inc.
• Trina Maize, BA
• Malcolm J. Dugas Jr.
• Sukhdeep Singh Malhi, M.D
• Glenn D. Manceaux, P.T., D.C., C.C.S.P.
• Jon Mangels, MD

• Nursing Facility/Intermediate Care Facility in Houma, LA
• Providers in Houma, LA by specialty
• Nursing Facility/Intermediate Care Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.