Organization
PINECREST DEVELOPMENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRI A EVANS (MR DD REGIONAL ADMINISTRATOR)
(318) 641-2003
Entity
Organization
Contact information
Practice address
2969 HIGHWAY 28 E, PINEVILLE, LA 71360-5716
(318) 641-2000
Mailing address
PO BOX 5191, PINEVILLE, LA 71361-5191
(318) 641-2000
(318) 641-2309
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
ADC 9419
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1157597
—
LA
Enumeration date
04/17/2007
Last updated
08/22/2020
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