Organization
ST. GENEVIVE HEALTH CARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA GRAHAM (DIRECTOR)
(318) 219-4101
Entity
Organization
Contact information
Practice address
6009 FINANCIAL PLZ STE 101, SHREVEPORT, LA 71129-2615
(318) 221-2566
Mailing address
6009 FINANCIAL PLZ STE 101, SHREVEPORT, LA 71129-2615
(318) 221-2566
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
PCA 11980
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1379018
—
LA
Enumeration date
04/17/2007
Last updated
10/15/2024
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