Organization
LOUISE S DAVIS RESIDENTIAL FACILITIES, LLC
Active
Other names
LOBDELL COMMUNITY HOME
Organization subpart
No
Provider details
NPI number
Authorized official
KENDALL A BROUSSARD (MANAGING MEMBER)
(337) 439-6600
Entity
Organization
Contact information
Practice address
10015 GREENWELL SPRINGS-PORT HUDSON RD, ZACHARY, LA 70791
(225) 654-8344
(225) 654-4240
Mailing address
10015 GREENWELL SPRINGS-PORT HUDSON RD, ZACHARY, LA 70791
(225) 654-8344
(225) 654-4240
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
1041
LA
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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