Organization
BETHESDA ADULT DAYCARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON MALLARD (OWNER)
(225) 303-4688
Entity
Organization
Contact information
Practice address
2289 BALIS DR, BATON ROUGE, LA 70808-1742
(225) 303-4688
Mailing address
2289 BALIS DR, BATON ROUGE, LA 70808-1742
(225) 303-4688
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
2203781483
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2203781483
—
LA
Enumeration date
01/21/2013
Last updated
01/21/2013
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