- Enrollment id
- O20230203001222
- Enrollment state
- LA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1346956927
- Multiple npi flag
- N
- Ccn
- 195491
- Associate id
- 5799157590
- Organization name
- DVILLE OPCO LLC
- Doing business as name
- CHATEAU D'VILLE REHAB AND RETIREMENT
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CHATEAU D'VILLE REHAB AND RETIREMENT
- Affiliation entity name
- PRIORITY MANAGEMENT
- Affiliation entity id
- 425
- Address line 1
- 401 VATICAN DR
- City
- DONALDSONVILLE
- State
- LA
- Zip code
- 703464017