Organization
CHRISTIAN REHABILITATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIQUE HALL LCSW (OWNER ADMINISTRATOR)
(225) 305-5647
Entity
Organization
Contact information
Practice address
4513 GREENWOOD LN, BAKER, LA 70714-2425
(225) 305-5647
Mailing address
4513 GREENWOOD LN, BAKER, LA 70714-2425
(225) 305-5647
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9810
LA
251B00000X
Case Management Agency
9810
LA
251S00000X
Community/Behavioral Health Agency
9810
LA
252Y00000X
Early Intervention Provider Agency
9810
LA
Other
Enumeration date
05/28/2015
Last updated
06/17/2016
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