# G B COOLEY SUPERVISED IND LIV

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285807255
- **Authorized official:** MR. JAMES L SANDERLIN CPA (DIRECTOR OF FINANCE)
- **Authorized official phone:** (318) 396-6300

## Contact information

- **Practice address:** 364 GB COOLEY RD, WEST MONROE, LA 71291-8866
- **Practice address phone:** (318) 396-6300
- **Practice address fax:** (318) 396-7663
- **Mailing address:** 364 GB COOLEY RD, WEST MONROE, LA 71291-8866
- **Mailing address phone:** (318) 396-6300
- **Mailing address fax:** (318) 396-7663

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | SIL6939 | LA | Yes |

## Other

- **Enumeration date:** 04/10/2008
- **Last updated:** 04/10/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1924342 | — | LA |