| NPI | 1083828776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN DARLENE DESSELLES Administrator 318-445-3141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: LA 311ZA0620X) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |