Provider Demographics
NPI:1487380127
Name:7 PELICANS LLC
Entity type:Organization
Organization Name:7 PELICANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:HENSGENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-684-6316
Mailing Address - Street 1:PO BOX 753
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-0753
Mailing Address - Country:US
Mailing Address - Phone:337-684-6316
Mailing Address - Fax:337-684-6315
Practice Address - Street 1:830 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CHURCH POINT
Practice Address - State:LA
Practice Address - Zip Code:70525-4402
Practice Address - Country:US
Practice Address - Phone:337-684-6313
Practice Address - Fax:337-684-6315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility