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Organization
HAVENS GATEWAY PERSONAL CARE FACILITY INC
Active
Organization
HAVENS GATEWAY PERSONAL CARE FACILITY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALFREDA CARTER JACKSON BA (PRESIDENT CEO)
(225) 343-4740
Entity
Organization
Contact information
Practice address
1200 S ACADIAN THRUWAY, 212, BATON ROUGE, LA 70806-6900
(225) 343-4740
(225) 343-4742
Mailing address
1200 S ACADIAN THRUWAY, 212, BATON ROUGE, LA 70806-6900
(225) 343-4740
(225) 343-4742
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PCA 6770
LA
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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