BAYOU INDUSTRIAL MAINTENANCE SERVICES
Adult Care Home
Berwick, Louisiana
Provider NPI: 1609080340
Organization Information:Organization Name: BAYOU INDUSTRIAL MAINTENANCE SERVICES
Practice Location:
2675 4TH ST BERWICK, LA 70342 US
Tel: 985-384-2003 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
2675 4TH ST BERWICK, LA 70342 US
Tel: 985-384-2003 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | LA | 2514 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
SUPERVISED INDEP. LIVING | 1919853 | LA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin