Provider Demographics
NPI:1306943873
Name:TOURO SHAKSPEARE,INC.
Entity type:Organization
Organization Name:TOURO SHAKSPEARE,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LUCIEN
Authorized Official - Suffix:
Authorized Official - Credentials:NFA
Authorized Official - Phone:225-303-6023
Mailing Address - Street 1:2621 GENERAL MEYERS AVE.
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:IA
Mailing Address - Zip Code:70114-3096
Mailing Address - Country:US
Mailing Address - Phone:225-303-6023
Mailing Address - Fax:504-246-1591
Practice Address - Street 1:14500 HAYNE BLVD.
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:IA
Practice Address - Zip Code:70128-1028
Practice Address - Country:US
Practice Address - Phone:504-246-1426
Practice Address - Fax:504-246-1591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA40314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA152O5O1Medicaid