# G B COOLEY HOSPITAL FOR RETARDED

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- **Entity:** Organization
- **Status:** Active
- **Other names:** G B Cooley Hospital Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154876837
- **Authorized official:** MR. JIMMY SANDERLIN CPA (CFO)
- **Authorized official phone:** (318) 397-6679

## Contact information

- **Practice address:** 211 N 3RD ST, MONROE, LA 71201-6731
- **Practice address phone:** (318) 397-6679
- **Practice address fax:** (318) 397-9271
- **Mailing address:** 211 N 3RD ST, MONROE, LA 71201-6731
- **Mailing address phone:** (318) 397-6679
- **Mailing address fax:** (318) 397-9271

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | NULL | Yes |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 08/23/2016
- **Last updated:** 08/23/2016