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
National Provider Directory
- Tax ID family
- Camelot of Broussard Assisted Living
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1521477 | Medicaid | LA |
Other names
- Magnolia Estates
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All providers in Lafayette, LA · Nursing Facility/Intermediate Care 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 Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.