Organization
HEAVENLY HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DOROTHY I NELSON (CEO)
(225) 357-7206
Entity
Organization
Contact information
Practice address
4824 E BROOKSTOWN DR, BATON ROUGE, LA 70805-3823
(225) 357-7206
(225) 357-6424
Mailing address
4824 E BROOKSTOWN DR, BATON ROUGE, LA 70805-3823
(225) 357-7206
(225) 357-6424
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/06/2007
Last updated
03/14/2008
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