| NPI | 1033223953 |
|---|---|
| Doing Business As | RAVENHEAD LIVING CENTER |
| Entity Type | Organization |
| Authorized Contact | JERRINE B HARRELL President 318-445-6470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: 116774) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-22 |