NPI | 1104954031 |
---|---|
Other Name | THIBAUT MANOR |
Entity Type | Organization |
Authorized Contact | WARREN GONZALES Executive Director 985-369-2908 |
Organization Subpart ? | No |
Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: LA 226) |
Enumeration Date | 2007-03-01 |
Last Update Date | 2008-06-23 |