Organization
ST. MARY'S RESIDENTIAL COMMUNITY AND SERVICES
Active
Parent organization
ST. MARY'S RESIDENTIAL COMMUNITY AND SERVICES
Other names
Clarks Manor
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. MARY'S RESIDENTIAL COMMUNITY AND SERVICES
Authorized official
KHRISTY ELLIS (CONTROLLER)
(318) 445-6443
Entity
Organization
Contact information
Practice address
2003 HUIE DELLMON AVE, BOYCE, LA 71409-9328
(318) 445-6443
Mailing address
PO BOX 7768, ALEXANDRIA, LA 71306-0768
(318) 445-6443
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MR0012749
LOUISIANA DEPARTMENT OF HEALTH
LA
Enumeration date
06/25/2021
Last updated
04/07/2026
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