# PEACH COMMUNITY HOME

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

## Provider details

- **NPI number:** 1609177757
- **Authorized official:** MS. KARA HENRY BERTRAND (ADMINISTRATOR)
- **Authorized official phone:** (318) 448-0291

## Contact information

- **Practice address:** 528 BOB WHITE LN, ALEXANDRIA, LA 71303-2415
- **Practice address phone:** (318) 787-6915
- **Mailing address:** 528 BOB WHITE LN, ALEXANDRIA, LA 71303-2415
- **Mailing address phone:** (318) 787-6915

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 16667 | LA | Yes |

## Other

- **Enumeration date:** 11/05/2010
- **Last updated:** 11/05/2010