| NPI | 1770623191 |
|---|---|
| Other Name | MARY MARCOMBE HOME |
| Entity Type | Organization |
| Authorized Contact | MARLENE BENOIT DOMINGUE Director 225-473-4516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X (Licence: LA 2341) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: LA 495) |
| 385H00000X Respite Care (Licence: LA 6675) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |