ANGEL MANOR- BREAUX BRIDGE NPI 1942330642

NPI Information

NPI: 1942330642
Provider Name: ANGEL MANOR- BREAUX BRIDGE
Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

Address:
329 W BRIDGE ST
BREAUX BRIDGE, LA
ZIP 70517
Phone: (337) 332-3421
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ANGEL MANOR- BREAUX BRIDGE is an adult day care clinic center in Breaux Bridge, LA. ANGEL MANOR- BREAUX BRIDGE NPI is 1942330642. The provider is registered as an organization entity type.

The provider's business location address is:

329 W BRIDGE ST
BREAUX BRIDGE, LA
ZIP 70517-040
Phone: (337) 332-3421
Fax: (337) 332-3461

The provider's authorized official is John Samuel Ford .
The authorized official title is Administrator and has the following contact phone number (337) 332-3421.

The enumeration date for this NPI number is 3/6/2007 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA0600X	Clinic/Center	Adult Day Care	251C00000X	LOUISIANA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1318744	MEDICAID	LOUISIANA

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: 5/5/2024

NPI Synchronization or Removal

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