| NPI | 1013670009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA REED Director Of Residential Services 225-383-9139 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2021-10-18 |