Organization
FIELDS DE LA NARURLAE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANETTE LITTLE MYLES S.W. (QMRP)
(318) 322-1910
Entity
Organization
Contact information
Practice address
2828 GAY DR, MONROE, LA 71202-6765
(318) 322-1910
(318) 322-1910
Mailing address
3660 HADLEY ST, MONROE, LA 71202-4556
(318) 322-1910
(318) 322-1910
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
192
LA
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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