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Organization

PINECREST DEVELOPMENTAL CENTER

Active
Other names
Angelina Drive Community Home
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RONALD WILLIAMS (ADMINISTRATOR)
(337) 239-2687
Entity
Organization

Contact information

Practice address
107 ANGELINA DRIVE, LEESVILLE, LA 71446
(337) 239-2687
Mailing address
PO BOX 131, LEESVILLE, LA 71496-0131
(337) 239-2687

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
1036
LA

Other

Enumeration date
12/16/2008
Last updated
03/25/2009
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