Provider Demographics
NPI:1902887052
Name:HESSMER NURSING HOME INC
Entity Type:Organization
Organization Name:HESSMER NURSING HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-253-6536
Mailing Address - Street 1:3707 HIGHWAY 114
Mailing Address - Street 2:
Mailing Address - City:HESSMER
Mailing Address - State:LA
Mailing Address - Zip Code:71341-4143
Mailing Address - Country:US
Mailing Address - Phone:318-563-4246
Mailing Address - Fax:318-563-9244
Practice Address - Street 1:3707 HIGHWAY 114
Practice Address - Street 2:
Practice Address - City:HESSMER
Practice Address - State:LA
Practice Address - Zip Code:71341-4143
Practice Address - Country:US
Practice Address - Phone:318-563-4246
Practice Address - Fax:318-563-9244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA194314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1513911Medicaid
LA1513911Medicaid
LA=========0OtherBCBS