Organization
WESTSIDE HABILITATION CENTER
Active
Parent organization
WESTSIDE HABILITATION CENTER, INC.
Other names
Harrison Group Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTSIDE HABILITATION CENTER, INC.
Authorized official
MS. CHRISTINA BONNETTE BOLTON (ADMINISTRATOR)
(318) 445-1551
Entity
Organization
Contact information
Practice address
5708 NORTH DR, ALEXANDRIA, LA 71301-2542
(318) 442-6540
(318) 442-6541
Mailing address
PO BOX 7917, ALEXANDRIA, LA 71306-0917
(318) 445-1551
(318) 445-1242
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
19G626
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19G626
—
LA
Enumeration date
03/19/2008
Last updated
11/05/2009
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