Organization
MARY MARCOMBE HOME
Active
Other names
DONALDSONVILLE AARC INC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLENE BENOIT DOMINGUE RN (EXECUTIVE DIRECTOR)
(225) 473-4516
Entity
Organization
Contact information
Practice address
1030 CLAY ST, DONALDSONVILLE, LA 70346-3518
(225) 473-4516
(225) 473-4517
Mailing address
1030 CLAY ST, PO BOX 624, DONALDSONVILLE, LA 70346-3518
(225) 473-4516
(225) 473-4517
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
495
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1717339
—
LA
Enumeration date
04/17/2007
Last updated
08/22/2020
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