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Organization
HAVENS GATEWAY PERSONAL CARE FACILITY INC
Active
Organization
HAVENS GATEWAY PERSONAL CARE FACILITY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALFREDA CARTER JACKSON BA (DIRECTOR ADMINISTRATOR)
(225) 343-4740
Entity
Organization
Contact information
Practice address
1200 S ACADIAN THRUWAY, 212, BATON ROUGE, LA 70806-6900
(225) 343-4740
(225) 343-4742
Mailing address
1200 S ACADIAN THRUWAY, 212, BATON ROUGE, LA 70806-6900
(225) 343-4740
(225) 343-4742
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
RC 13015
LA
Other
Enumeration date
06/09/2008
Last updated
11/20/2008
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