1609215391 NPI number — POST ACUTE HOLDINGS LLC

Table of content: LINDA GOBBERDIEL RD LD (NPI 1730449463)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609215391 NPI number — POST ACUTE HOLDINGS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
POST ACUTE HOLDINGS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609215391
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
950 W CAUSEWAY APPROACH
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANDEVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70471-3082
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-324-8950
Provider Business Mailing Address Fax Number:
985-624-3477

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5407 INDIAN HILL BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DIAMONDHEAD
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39525-3324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
228-687-1385
Provider Business Practice Location Address Fax Number:
504-227-3511
Provider Enumeration Date:
06/17/2013

Additional Information

Authorized Official

Authorized Official Last Name:
PSARELLIS
Authorized Official First Name:
DAWN
Authorized Official Middle Name:
HARVEY
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
504-324-8950

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  026 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00070669 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 026 . This is a "MISSISSIPPI STATE DEPT OF HEALTH" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".




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