Heritage Manor South

LBN: Community Care Center Of Shreveport South Llc
Heritage Manor South is an health care organization with primary practice located at 9712 Mansfield Rd , Shreveport LA 71118-4406. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Community Care Center Of Shreveport South Llc can be contacted via phone (318) 687-2080, or through Parkinson, Toni via phone (601) 709-1408.

Contact Information

Primary practice address
9712 Mansfield Rd Shreveport LA 71118-4406
Phone: (318) 687-2080
Fax: (318) 688-8103
Website:
Map and Directions
Authorized official contact:
Name: Parkinson, Toni
Phone: (601) 709-1408

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 784 Louisiana

Profile Details

NPI number 1083662944
LBN Legal business name Community Care Center Of Shreveport South Llc
DBA Doing business as Heritage Manor South
Authorized official Parkinson, Toni
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2006
Last updated May 3rd, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083662944 NPPES
Louisiana MEDICAID 1521434
Louisiana Other 31054

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