NPI | 1679788467 |
---|---|
Other Name | EAST DRIVE CH |
Entity Type | Organization |
Authorized Contact | COLLIS BENTON TEMPLE, JR. Executive Director 225-383-9139 |
Organization Subpart ? | No |
Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: LA 469) |
Enumeration Date | 2007-05-14 |
Last Update Date | 2020-08-22 |