Organization
FAMILIESFIRSTCHOICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA MARTIN (DIRECTOR)
(318) 387-5484
Entity
Organization
Contact information
Practice address
2809 EVANGELINE ST, SUITE3, MONROE, LA 71201-3776
(318) 387-5484
(318) 387-5547
Mailing address
2809 EVANGELINE ST, SUITE3, MONROE, LA 71201-3776
(318) 387-5484
(318) 387-5547
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1438677
—
LA
Enumeration date
05/16/2007
Last updated
08/22/2020
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