# COLUMBIA DEVELOPMENTAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Banks Springs Group Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013136613
- **Authorized official:** MR. MICHAEL ANTHONY HARRELL (REGIONAL ASSOCIATE ADMINISTRATOR)
- **Authorized official phone:** (318) 649-6097

## Contact information

- **Practice address:** 132 HIGHWAY 850, COLUMBIA, LA 71418-1559
- **Practice address phone:** (318) 649-6097
- **Practice address fax:** (318) 649-2868
- **Mailing address:** 132 HIGHWAY 850, P. O. BOX 1559, COLUMBIA, LA 71418-1559
- **Mailing address phone:** (318) 649-6097
- **Mailing address fax:** (318) 649-2868

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 454 | LA | Yes |

## Other

- **Enumeration date:** 04/24/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1712060 | — | LA |