Basic Information
| Provider Information | |||||||||
| NPI: | 1689174153 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPITAL OAKS NURSING & REHABILITATION CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1438 | ||||||||
| Address2: | |||||||||
| City: | WINNFIELD | ||||||||
| State: | LA | ||||||||
| PostalCode: | 714831438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186284116 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4100 NORTH BLVD | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708063911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2253876704 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2018 | ||||||||
| LastUpdateDate: | 08/04/2018 | ||||||||
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| AuthorizedOfficialLastName: | PRICE | ||||||||
| AuthorizedOfficialFirstName: | TEDDY | ||||||||
| AuthorizedOfficialMiddleName: | RAY | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER/CEO | ||||||||
| AuthorizedOfficialTelephone: | 3186484116 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.