| NPI | 1447456140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PORSHA RADFORD Director 225-291-5038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: LA PCA 12825) |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: LA SIL 12826) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2020-08-22 |