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Organization

LEESVILLE DEVELOPMENTAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TOMMY BROOKS (FACILITY SERVICES DIRECTOR)
(337) 239-2687
Entity
Organization

Contact information

Practice address
200 S 8TH ST, LEESVILLE, LA 71446-4208
(337) 239-2687
Mailing address
PO BOX 131, LEESVILLE, LA 71496-0131
(337) 239-2687
(337) 238-3723

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1712043
LA
Enumeration date
04/25/2007
Last updated
08/22/2020
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