Provincial Community Home Inc in Mansfield - Intermediate Care Facility, Intellectual Disabilities
Provincial Community Home Inc - NPI 1780894477
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 1780894477. The last update date is 2020-08-22.
Provincial Community Home Inc's current location address is 167 Poole Road, Mansfield, Louisiana. You can contact this provider via phone number 3188720206 and fax number 3188728833. The mailing address for Provincial Community Home Inc is 167 Poole Road, Mansfield, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Provincial Community Home Inc |
|---|---|
| Address | 167 Poole Road, Mansfield, Louisiana |
| Phone Number | 3188720206 |
| 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 | 1780894477 |
|---|---|
| Provider Enumeration Date | 2007-05-23 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 167 Poole Road |
|---|---|
| City | Mansfield |
| State | Louisiana (LA) |
| Post Code | 710525007 |
| Phone Number | 3188720206 |
| Fax Number | 3188728833 |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
| Licence No | 636 |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1718971 | LA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Provincial Community Home Inc by the Centers for Medicare & Medicaid Services?
The Provincial Community Home Inc has been assigned the NPI (National Provider Identifier) 1780894477 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete address where Provincial Community Home Inc is physically located?
The Provincial Community Home Inc is situated at the following address: 167 Poole Road, Mansfield, LA 710525007.
What is Provincial Community Home Inc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Provincial Community Home Inc's area of specialization is Intermediate Care Facility, Intellectual Disabilities, and the corresponding taxonomy code that categorizes this field of practice is 315P00000X.
On what date was the 1780894477 assigned to Provincial Community Home Inc?
The Provincial Community Home Inc was issued its 1780894477 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 regarding Provincial Community Home Inc most recently updated?
The details pertaining to the Provincial Community Home Inc, including its address, specialty, and other relevant information, were last refreshed on 2020-08-22.