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SOUTHERN COMFORT COMMUNITY HOMES LLC NPI 1700904570


NPI Information

NPI: 1700904570
Provider Name: SOUTHERN COMFORT COMMUNITY HOMES, LLC

Doing Business As: EDWIN DRIVE GROUP HOME

Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization
Address:
134 HABETZ LOOP
RAYNE, LA
ZIP 70578
Phone: (337) 363-2969
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SOUTHERN COMFORT COMMUNITY HOMES, LLC is a nursing facility intermediate care facility in Rayne, LA. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. SOUTHERN COMFORT COMMUNITY HOMES, LLC NPI is 1700904570. The provider is registered as an organization entity type.
The provider Is Doing Business As Edwin Drive Group Home.

The provider's business location address is:

134 HABETZ LOOP
RAYNE, LA
ZIP 70578-627
Phone: (337) 363-2969
Fax: (337) 363-5974

The provider's authorized official is Carolyn Deranger .
The authorized official title is Office Manager and has the following contact phone number (337) 363-2969.

The enumeration date for this NPI number is 3/27/2007 and was last updated on 8/22/2020.


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
1313M00000XNursing Facility/Intermediate Care Facility917LOUISIANAYes

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
11710491MEDICAIDLOUISIANA

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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