Organization
PECAN GROVE TRAINING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA E DUFOUR (ACCOUNTING)
(318) 445-1635
Entity
Organization
Contact information
Practice address
5000 3RD ST, ALEXANDRIA, LA 71302-5103
(318) 445-1635
(318) 473-0490
Mailing address
3844 INDEPENDENCE DR, ALEXANDRIA, LA 71303-3533
(318) 445-1635
(318) 473-0490
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
10/11/2006
Last updated
08/22/2020
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