Organization
THE ARC OF SABINE INC
Active
Other names
VIRGINIA GODFREY COMMUNITY HOME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CALVIN WAYNE MARTINEZ (EXEC DIRECTOR)
(318) 256-2025
Entity
Organization
Contact information
Practice address
700 DOCKENS DR, MANY, LA 71449
(318) 256-5155
(315) 256-0143
Mailing address
PO BOX 1150, MANY, LA 71449-1150
(318) 256-2025
(318) 256-0143
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1717061
—
LA
01
—
19G465
DHH PROVIDER #
LA
Enumeration date
03/07/2007
Last updated
08/22/2020
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