Organization
TAFT COMMUNITY HOME
Active
Parent organization
WESTSIDE HABILITATION CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTSIDE HABILITATION CENTER
Authorized official
CHRISTINA BONNETTE BOLTON (ADMINISTRATOR)
(318) 445-1551
Entity
Organization
Contact information
Practice address
4314 WHITEFIELD BLVD, ALEXANDRIA, LA 71303-2925
(318) 449-8787
(318) 449-8782
Mailing address
PO BOX 7917, ALEXANDRIA, LA 71306-0917
(318) 445-1551
(318) 445-1242
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
1053
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19G653
—
LA
Enumeration date
04/17/2009
Last updated
11/05/2009
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