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Organization
MELBROOK COMMUNITY HOME
Active
Organization
MELBROOK COMMUNITY HOME
Active
Parent organization
CROSSROADS LOUISIANA, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CROSSROADS LOUISIANA, INC.
Authorized official
MS. SUSAN MCILWAIN (EXECUTIVE DIRECTOR)
(504) 366-1828
Entity
Organization
Contact information
Practice address
336 MELBROOK DR, GRETNA, LA 70056-7715
(504) 366-1828
(504) 366-1867
Mailing address
PO BOX 6987, NEW ORLEANS, LA 70174-6987
(504) 366-1828
(504) 366-1867
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454257
—
LA
05
—
1718289
—
LA
05
—
1718378
—
LA
05
—
1719595
—
LA
05
—
1719684
—
LA
05
—
1910074
—
LA
05
—
1918571
—
LA
Enumeration date
10/23/2008
Last updated
10/23/2008
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