# HOLY ANGELS RESIDENTIAL FACILITY

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

## Provider details

- **NPI number:** 1477633014
- **Authorized official:** SR. CONCETTA SCIPIONE OLS (ADMINISTRATOR/CEO)
- **Authorized official phone:** (318) 797-8500

## Contact information

- **Practice address:** 10450 ELLERBE RD, SHREVEPORT, LA 71106-7712
- **Practice address phone:** (318) 797-8500
- **Practice address fax:** (318) 797-8599
- **Mailing address:** 10450 ELLERBE RD, SHREVEPORT, LA 71106-7712
- **Mailing address phone:** (318) 797-8500
- **Mailing address fax:** (318) 797-8599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 124 | LA | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 08/22/2020