# BOGALUSA RESTORATION CENTER, LLC

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

## Provider details

- **NPI number:** 1487137626
- **Authorized official:** MRS. JENNIFER REILING MSS,CP (CHIEF STRATEGIC OFFICER)
- **Authorized official phone:** (985) 241-5340

## Contact information

- **Practice address:** 1640 S COLUMBIA ST, BOGALUSA, LA 70427-5800
- **Practice address phone:** (985) 241-5340
- **Practice address fax:** (985) 241-5341
- **Mailing address:** 1640 S COLUMBIA ST, BOGALUSA, LA 70427-5800
- **Mailing address phone:** (985) 241-5340
- **Mailing address fax:** (985) 241-5341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253J00000X | Foster Care Agency | — | NULL | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | — |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/13/2018
- **Last updated:** 11/14/2018