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Organization

SHEKINAH GLORY MINISTRY OF BATON ROUGE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DEBRA DENISE CARTER (PASTOR)
(225) 924-4575
Entity
Organization

Contact information

Practice address
3613 GOVERNMENT ST, BATON ROUGE, LA 70806-5721
(225) 346-5225
(225) 346-5225
Mailing address
PO BOX 53766, BATON ROUGE, LA 70892-3766
(225) 924-4575
(225) 924-4574

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
SIL 12514
LA
320700000X
Physical Disabilities Residential Treatment Facility
Primary
PCA 12390
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1351407
LA
Enumeration date
04/19/2007
Last updated
09/25/2007
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