Organization
CEREBRAL PALSY ASSOCIATION OF G.B.R., INC.
Active
Other names
MCMAINS CHILDREN'S DEVELOPMENTAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET C. KETCHAM LCSW (EXECUTIVE DIRECTOR)
(225) 923-3420
Entity
Organization
Contact information
Practice address
1805 COLLEGE DR, BATON ROUGE, LA 70808-1919
(225) 923-3420
(225) 922-9316
Mailing address
1805 COLLEGE DR, BATON ROUGE, LA 70808-1919
(225) 923-3420
(225) 922-9316
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02587
BLUE CROSS PROVIDER
LA
05
—
1394149
—
LA
05
—
1930423
—
LA
Enumeration date
06/08/2005
Last updated
08/22/2020
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