Cb's Place Group Home

NPI 1073732954 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1073732954
Enumeration Date 04/25/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name COLLIS BENTON COLLIS
Position EXECUTIVE DIRECTOR
Phone (225) 383-9139
Fax (225) 336-5431
Practice Location
2736 FLORIDA BLVD
BATON ROUGE LA, 70802-2719, US
Phone (225) 383-9139
Fax (225) 336-5431
Business Location
1560 C B TEMPLE RD
KENTWOOD LA, 70444-3005, US
Phone (225) 383-9139
Fax (225) 336-5431
Toxanomy
Taxonomy Code 320600000X
License State Louisiana
License Number 1004
Remove 1073732954 NPI Number
 

According to our database, Cb's Place Group Home NPI is 1073732954, taxonomy code is 320600000X and license number is 1004, license state is located at Louisiana. Cb's Place Group Home physically located at 2736 Florida Blvd, Baton Rouge LA, 70802-2719. NPI Number 1033115704 has the healthcare provider type.

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1073732954 NPI number is provided on an as is basis without warranty of any kind. 1073732954 is maintained by the National Plan & Provider Enumeration System. The contents of Cb's Place Group Home are for informational purposes only.