Organization
COLWELL INTEREST, INC.
Active
Parent organization
COLWELL INTEREST, INC.
Other names
Pecan Grove Community Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLWELL INTEREST, INC.
Authorized official
MR. JAMES B. COLWELL (PROGRAM MANAGER)
(318) 442-2284
Entity
Organization
Contact information
Practice address
167 POOLE RD, MANSFIELD, LA 71052-5007
(318) 442-2284
(318) 448-1427
Mailing address
1111 MAIN ST, PINEVILLE, LA 71360-6423
(318) 442-2284
(318) 448-1427
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
1062
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1718971
—
LA
Enumeration date
11/24/2009
Last updated
11/24/2009
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