Organization
LEESVILLE DEVELOPMENTAL CENTER
Active
Other names
Amanda Rock Community Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOMMY BROOKS (FACILITY SERVICES DIRECTOR)
(337) 239-2687
Entity
Organization
Contact information
Practice address
301 KNAPP ST, LEESVILLE, LA 71446-3035
(337) 238-6448
Mailing address
PO BOX 131, LEESVILLE, LA 71496-0131
(337) 239-2687
(337) 238-3723
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
273
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1712124
—
LA
Enumeration date
04/25/2007
Last updated
06/18/2008
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