Organization
G B COOLEY SUPERVISED IND LIV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES L SANDERLIN CPA (DIRECTOR OF FINANCE)
(318) 396-6300
Entity
Organization
Contact information
Practice address
364 GB COOLEY RD, WEST MONROE, LA 71291-8866
(318) 396-6300
(318) 396-7663
Mailing address
364 GB COOLEY RD, WEST MONROE, LA 71291-8866
(318) 396-6300
(318) 396-7663
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
SIL6939
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1924342
—
LA
Enumeration date
04/10/2008
Last updated
04/10/2008
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