Organization
HOLY ANGELS RESIDENTIAL FACILITY
Active
Other names
Fay Home
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA LANDRY HORNE CPA (DIRECTOR OF FINANCE)
(318) 797-8500
Entity
Organization
Contact information
Practice address
10450 ELLERBE RD, SHREVEPORT, LA 71106-7712
(318) 797-8500
(318) 798-0159
Mailing address
10450 ELLERBE RD, SHREVEPORT, LA 71106-7712
(318) 797-8500
(318) 798-0159
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710962
—
LA
Enumeration date
04/24/2007
Last updated
05/27/2022
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