Organization Name: | PROGRESSIVE ACUTE CARE OAKDALE, LLC |
NPI Number: | 1043513385 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONNA VARNADO (MANAGER) |
Mailing Address: | 11424 Hwy 165 South Forest Hill |
State: | LA US |
Postal Code: | 71430 |
Phone Number: | 3187484645 |
Fax Number: | 3187484689 |
NPI Enumeration Date: | 12/08/2010 |
NPI Last Update Date: | 12/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |