Organization
PURPOSE RESIDENTIAL HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA FAY WILLIAMS LPN (CO OWNER)
(225) 978-3447
Entity
Organization
Contact information
Practice address
3024 WESTFORK DR STE B, BATON ROUGE, LA 70816-2252
(225) 229-3254
(225) 380-2171
Mailing address
3024 WESTFORK DR STE B, BATON ROUGE, LA 70816-2252
(225) 229-3254
(225) 380-2171
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/27/2021
Last updated
08/27/2021
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