| NPI | 1356499040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS RYLAND Regional Vice President 318-949-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: LA 164) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2025-05-27 |