Organization
PINECREST SUPPORTS AND SERVICES CENTER
Active
Other names
Oak Run Community Home
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRI A EVANS (MR DD REGIONAL ADMINISTRATOR)
(318) 641-2003
Entity
Organization
Contact information
Practice address
224 ROBERTSON RD, BALL, LA 71405-3863
(318) 640-3955
(318) 640-3955
Mailing address
P. O. BOX 5191, ATTENTION: QMI, PINEVILLE, LA 71361-5191
(318) 641-2000
(318) 641-2309
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
1023
LA
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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