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Organization
HOLY ANGELS RESIDENTIAL FACILITY
Active
Organization
HOLY ANGELS RESIDENTIAL FACILITY
Active
Other names
Wenzel Home
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA LANDRY HORNE CPA (DIRECTOR OF FINANCE)
(318) 797-8500
Entity
Organization
Contact information
Practice address
10450 ELLERBE RD, SHREVEPORT, LA 71106-7712
(318) 797-8500
(318) 798-0159
Mailing address
10450 ELLERBE RD, SHREVEPORT, LA 71106-7712
(318) 797-8500
(318) 798-0159
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
930
LA
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1711225
—
LA
Enumeration date
04/24/2007
Last updated
05/27/2022
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