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SENIORS CLUB NPI 1487870366


NPI Information

NPI: 1487870366
Provider Name: SENIORS CLUB
Classification: Custodial Care Facility - 311Z00000X
Entity Type: Organization
Address:
2653 MALCOLM ST
SHREVEPORT, LA
ZIP 71108
Phone: (318) 635-0010
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SENIORS CLUB is a custodial care facility in Shreveport, LA. The provider is a facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. SENIORS CLUB NPI is 1487870366. The provider is registered as an organization entity type.

The provider's business location address is:

2653 MALCOLM ST
SHREVEPORT, LA
ZIP 71108-720
Phone: (318) 635-0010
Fax: (318) 635-8844

The provider's authorized official is Karen R. Mccoy .
The authorized official title is Executive Director and has the following contact phone number (318) 635-0010.

The enumeration date for this NPI number is 4/18/2007 and was last updated on 6/23/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311Z00000XCustodial Care Facility7392LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11172596MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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