Organization
PEACH COMMUNITY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KARA HENRY BERTRAND (ADMINISTRATOR)
(318) 448-0291
Entity
Organization
Contact information
Practice address
528 BOB WHITE LN, ALEXANDRIA, LA 71303-2415
(318) 787-6915
Mailing address
528 BOB WHITE LN, ALEXANDRIA, LA 71303-2415
(318) 787-6915
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
16667
LA
Other
Enumeration date
11/05/2010
Last updated
11/05/2010
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