Organization
MEDICAL MANAGEMENT ENTERPRISES INC
Active
Other names
Ridgeway House
Organization subpart
No
Provider details
NPI number
Authorized official
GARY W. BORG (VICE-PRESIDENT)
(225) 644-7994
Entity
Organization
Contact information
Practice address
1808 S SHIRLEY AVE, GONZALES, LA 70737-3922
(225) 644-7994
Mailing address
PO BOX 571, GONZALES, LA 70707-0571
(225) 644-7994
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
707
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1719722
—
LA
Enumeration date
06/21/2007
Last updated
06/13/2008
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