Louisiana Guest House

Organization Active NPI Nursing Facility/Intermediate Care Facility · Lafayette, LA

NPI 1962587816 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1962587816
Entity type
Organization (NPI type 2)
Primary specialty
Nursing Facility/Intermediate Care Facility 313M00000X
License
923 (LA)
Legal business name
LOUISIANA GUEST HOUSE
Practice address
1511 Dulles Dr
Lafayette, LA 70506-3718
Phone
(337) 216-0950
Fax
(337) 216-0994
NPI assigned
Oct 26, 2006
Organization subpart
No

Authorized official

Name
Carey Hotard
Title
Administrator
Phone
(337) 216-0950

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Camelot of Broussard Assisted Living (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 923 LA Yes

Addresses

Primary practice location

1511 Dulles Dr
Lafayette, LA 70506-3718

Mailing address

1511 Dulles Dr
Lafayette, LA 70506-3718
Phone (337) 216-0950

Other identifiers

IdentifierTypeStateIssuer
1521477MedicaidLA

Other names

  • Magnolia Estates Doing business as

Other providers in Lafayette, LA

All providers in Lafayette, LA · Nursing Facility/Intermediate Care Facility in Louisiana

Sources for this page

Verify at the official NPI Registry.