Southeast Louisiana Veterans Home
Organization Active NPI Skilled Nursing Facility · Reserve, LA
NPI 1770635211 · NPPES record last updated Feb 23, 2017
Key facts
- NPI
- 1770635211
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- SOUTHEAST LOUISIANA VETERANS HOME
- Practice address
- 4080 W Airline Hwy
Reserve, LA 70084-5712 - Phone
- (985) 479-4080
- Fax
- (985) 479-4090
- NPI assigned
- Jan 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Cleveland J Obey Jr.
- Title
- LTC Administrator
- Phone
- (985) 479-4080
Corporate family (same tax ID) 1
Facilities with the same owner 3
Affiliated clinicians 1
-
Andrew J St Martin, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Southeast Louisiana War Veterans Home
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★★ 5 of 5
- Type
- Medicare
- Ownership
- Government - State
- Certified
- Aug 7, 2007
- Medicare certification status
- Active
- Certified beds
- 8 · 1.0 residents per day on average
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Skilled nursing facility certification: CCN 195625
- Legal name
- SOUTHEAST LOUISIANA VETERANS HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- Aug 7, 2007
- Last certification
- May 22, 2024
- Beds
- 8
- Ownership / control type
- State
- Multi-facility organization
- Louisiana Department of Veterans Affairs
- Organization structure
- Other · Non-profit
- Incorporated
- Feb 16, 2006 in LA
- Enrollment address
- 4080 W Airline Hwy
Reserve, LA 70084-5712 - Nursing home name
- SOUTHEAST LOUISIANA WAR VETERANS HOME
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Brian Fremin |
Corporate Director |
Jun 12, 2017 | |
| State of la, Dept of Veterans Affairs |
5% Or Greater Direct Ownership Interest | Jan 29, 2007 | |
| Kelly Roche |
Corporate Director | Feb 5, 2018 | |
| Operational/Managerial Control | Nov 12, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070315000527 | LA | Part a Provider - Skilled Nursing Facility | 9931202744 | Practice locations: Reserve, LA |
National Provider Directory
- Tax ID family
- Southeast Louisiana Veterans Home
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Hospital | 282E00000X | LA | ||
| Skilled Nursing Facility | 314000000X | LA | Yes |
Addresses
Primary practice location
4080 W Airline Hwy
Reserve, LA 70084-5712
Mailing address
4080 W Airline Hwy
Reserve, LA 70084-5712
Phone (985) 479-4080
Other names
- Southeast Louisiana War Veterans Home
Other providers in Reserve, LA
- Elizabeth Rousseve
- Olivia Nicole Schouest
- Heydie Karen Sciacca
- Van R Small Jr.
- Amber Lynn Smith
- Southeast Louisiana War Veterans Home
- Denis Hubert St. Pierre
- Sanjanette Burl Taylor
- Teche Action Board Inc
- Teche Action Board, Inc.
All providers in Reserve, LA · Skilled Nursing Facility in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.