Provider Demographics
NPI:1285242347
Name:LANE SENIOR CARE LLC
Entity type:Organization
Organization Name:LANE SENIOR CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-405-4144
Mailing Address - Street 1:6170 CARPENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-4041
Mailing Address - Country:US
Mailing Address - Phone:225-658-4345
Mailing Address - Fax:225-658-4192
Practice Address - Street 1:6170 CARPENTER DRIVE
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-4041
Practice Address - Country:US
Practice Address - Phone:225-658-4345
Practice Address - Fax:225-658-4192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-15
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility