# NORTHLAKE SUPPORTS AND SERVICES CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTHLAKE SUPPORTS AND SERVICES CENTER
- **Other names:** Ivy Springs Community Home
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710150446
- **Legal business name:** NORTHLAKE SUPPORTS AND SERVICES CENTER
- **Authorized official:** MR. RONALD WILLIAMS (ADMINISTRATOR)
- **Authorized official phone:** (225) 567-3111

## Contact information

- **Practice address:** 27683 IVY SPRINGS DRIVE, INDEPENDENCE, LA 70443
- **Practice address phone:** (225) 567-3111
- **Mailing address:** 45439 LIVE OAK DR, HAMMOND, LA 70401-4526
- **Mailing address phone:** (225) 567-3111

## Taxonomy

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

## Other

- **Enumeration date:** 04/02/2008
- **Last updated:** 04/02/2008