Roosevelt Community Home

NPI 1174766364 - Intermediate Care Facility, Mentally Retarded - 315P00000X

NPI Details
NPI 1174766364
Enumeration Date 04/17/2009
Last Updated 11/07/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name CHRISTINA BONNETTE CHRISTINA
Position ADMINISTRATOR
Phone (318) 443-9330
Fax (318) 443-9359
Practice Location
1605 TEXAS AVE
ALEXANDRIA LA, 71301-4050, US
Phone (318) 443-9330
Fax (318) 443-9359
Business Location
PO BOX 7917
ALEXANDRIA LA, 71306-0917, US
Phone (318) 445-1551
Fax (318) 445-1242
Toxanomy
Taxonomy Code 315P00000X
License State Louisiana
License Number 1054
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According to our database, Roosevelt Community Home NPI is 1174766364, taxonomy code is 315P00000X and license number is 1054, license state is located at Louisiana. Roosevelt Community Home physically located at 1605 Texas Ave, Alexandria LA, 71301-4050. NPI Number 1033115704 has the healthcare provider type.

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1174766364 NPI number is provided on an as is basis without warranty of any kind. 1174766364 is maintained by the National Plan & Provider Enumeration System. The contents of Roosevelt Community Home are for informational purposes only.