Organization
CALCASIEU MULTI-HANDICAPPED CENTER, LLC
Active
Other names
CALCASIEU GROUP HOME IV
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH FELLOWS (CEO)
(816) 444-0900
Entity
Organization
Contact information
Practice address
1101 NONA ST, VINTON, LA 70668-4123
(337) 589-6292
Mailing address
1101 NONA ST, VINTON, LA 70668-4123
(337) 589-6292
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
746
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1713031
—
LA
Enumeration date
08/16/2005
Last updated
08/22/2020
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