- Enrollment id
- O20160302001140
- Enrollment state
- LA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1699147694
- Multiple npi flag
- N
- Ccn
- 195204
- Associate id
- 9133422926
- Organization name
- PRIORITY GROUP HOLDINGS, L.L.C.
- Doing business as name
- JO ELLEN SMITH CONVALESCENT CENTER
- Incorporation date
- 2015-07-23
- Incorporation state
- LA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- JO ELLEN SMITH CONVALESCENT CENTER
- Affiliation entity name
- PRIORITY MANAGEMENT
- Affiliation entity id
- 425
- Address line 1
- 4502 GENERAL MEYER AVE
- City
- NEW ORLEANS
- State
- LA
- Zip code
- 701313531