Provincial Community Home Inc in Mansfield - Intermediate Care Facility, Intellectual Disabilities
Provincial Community Home Inc - NPI 1659581379
Provincial Community Home Inc is a Intermediate Care Facility, Intellectual Disabilities in Mansfield, Louisiana. Provincial Community Home Inc practices all healthcare services and medical treatments related to Intermediate Care Facility, Intellectual Disabilities. The NPI Number for Provincial Community Home Inc is 1659581379. The last update date is 2020-08-22.
Provincial Community Home Inc's current location address is 416 Gibbs Street, Mansfield, Louisiana. You can contact this provider via phone number 3188726817 and fax number 3188728833. The mailing address for Provincial Community Home Inc is 416 Gibbs Street, Mansfield, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Provincial Community Home Inc |
|---|---|
| Address | 416 Gibbs Street, Mansfield, Louisiana |
| Phone Number | 3188726817 |
| Fax Number | 3188728833 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | ADMINISTRA |
|---|---|
| Authorized Official Name | Terrell Drew Johnny |
| Telephone Number | 3188720206 |
NPI Number Detail
| NPI Number | 1659581379 |
|---|---|
| Provider Enumeration Date | 2007-05-23 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 416 Gibbs Street |
|---|---|
| City | Mansfield |
| State | Louisiana (LA) |
| Post Code | 710522618 |
| Phone Number | 3188726817 |
| Fax Number | 3188728833 |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
| Licence No | 659 |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1719323 | LA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Provincial Community Home Inc?
The Provincial Community Home Inc has been issued the NPI (National Provider Identifier) 1659581379 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the Provincial Community Home Inc located?
The Provincial Community Home Inc is located at 416 Gibbs Street, Mansfield, LA 710522618.
What is Provincial Community Home Inc's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Provincial Community Home Inc is Intermediate Care Facility, Intellectual Disabilities, and the taxonomy code that categorizes this field of expertise is 315P00000X.
On what date was the 1659581379 assigned to Provincial Community Home Inc?
The Provincial Community Home Inc was issued its 1659581379 on 2007-05-23, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Provincial Community Home Inc most recently updated or revised?
The details related to Provincial Community Home Inc, including its address, specialty, and other relevant information, were last updated or revised on 2020-08-22.
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