- Enrollment id
- O20121029000290
- Enrollment state
- LA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1629013404
- Multiple npi flag
- N
- Ccn
- 195304
- Associate id
- 1850541822
- Organization name
- RIVERLANDS HOME GROUP LLC
- Doing business as name
- CHATEAU ST JAMES REHAB AND RETIREMENT
- Incorporation date
- 2012-06-11
- Incorporation state
- LA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CHATEAU ST. JAMES REHAB AND RETIREMENT
- Affiliation entity name
- PRIORITY MANAGEMENT
- Affiliation entity id
- 425
- Address line 1
- 1980 JEFFERSON HIGHWAY
- City
- LUTCHER
- State
- LA
- Zip code
- 700715119