# G B COOLEY-WILLOW GROUP HOME

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1427299767
- **Authorized official:** TED CALLOWAY (CFO)
- **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:** 211 N 3RD ST, MONROE, LA 71201-6731
- **Mailing address phone:** (318) 396-3000
- **Mailing address fax:** (318) 396-7663

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 1049 | LA | Yes |

## Other

- **Enumeration date:** 03/17/2009
- **Last updated:** 11/15/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1049 | — | LA |