Organization
HAVEN'S GATEWAY PERSONAL CARE FACILITY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALFREDA JACKSON B.A. (PRESIDENT/C.E.O.)
(225) 343-4741
Entity
Organization
Contact information
Practice address
1200 S ACADIAN THRUWAY STE 211, BATON ROUGE, LA 70806-6900
(225) 266-2092
(225) 343-4742
Mailing address
1200 S ACADIAN THRUWAY STE 212, BATON ROUGE, LA 70806-6900
(225) 226-2092
(225) 343-4742
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
SIL 6698
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1581348
—
LA
Enumeration date
04/04/2007
Last updated
06/05/2008
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