| NPI | 1174749626 |
|---|---|
| Doing Business As | RAVENHEAD LIVING CENTER |
| Entity Type | Organization |
| Authorized Contact | JAMES E. RICHARDSON Attorney 318-445-6470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |