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Custodial Care Facility

Shreveport, Louisiana

Provider NPI: 1417079526

Organization Information:
Organization Name:  SENIORS CLUB

Practice Location:
Tel: 318-635-0010  Fax: --

Business Mailing Address:
Tel: --  Fax: --


PrimaryCodeCategory/DescriptionStateLicense Number
Y311Z00000XNursing & Custodial Care Facilities
Custodial Care Facility

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


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