# LEESVILLE DEVELOPMENTAL CENTER

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

## Provider details

- **NPI number:** 1689893646
- **Authorized official:** MR. TOMMY BROOKS (FACILITY SERVICES DIRECTOR)
- **Authorized official phone:** (337) 239-2687

## Contact information

- **Practice address:** 200 S 8TH ST, LEESVILLE, LA 71446-4208
- **Practice address phone:** (337) 239-2687
- **Mailing address:** PO BOX 131, LEESVILLE, LA 71496-0131
- **Mailing address phone:** (337) 239-2687
- **Mailing address fax:** (337) 238-3723

## Taxonomy

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

## Other

- **Enumeration date:** 04/25/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1712043 | — | LA |