Organization
PROVISIONS CARE AND RESIDENTIAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLETTE MARIE MINOR (OWNER/ADMINISTRATOR)
(225) 775-8188
Entity
Organization
Contact information
Practice address
7125 VILLERE DR, BAKER, LA 70714-5347
(225) 775-8188
(225) 775-8189
Mailing address
7125 VILLERE DR, BAKER, LA 70714-5347
(225) 775-8188
(225) 775-8189
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
LA
Other
Enumeration date
08/22/2013
Last updated
08/22/2013
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