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Organization

WENDOVER COMMUNITY HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. EARL HUMPHRIES (OWNER)
(318) 445-1635
Entity
Organization

Contact information

Practice address
4607 WENDOVER BLVD, ALEXANDRIA, LA 71303-2528
(318) 445-1635
(318) 473-0490
Mailing address
4607 WENDOVER BLVD, ALEXANDRIA, LA 71303-2528
(318) 445-1635
(318) 473-0490

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary

Other

Enumeration date
03/30/2015
Last updated
04/23/2015
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