Organization
FAMILY LIFE DEVELOPMENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALPHONSO BINGHAM (ADMINISTRATOR)
(318) 255-8405
Entity
Organization
Contact information
Practice address
829 E GEORGIA AVE STE 5, RUSTON, LA 71270-3901
(318) 255-8404
(318) 255-8417
Mailing address
829 E GEORGIA AVE STE 5, RUSTON, LA 71270-3901
(318) 255-8404
(318) 255-8417
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
7222
LA
Other
Enumeration date
07/01/2007
Last updated
05/27/2008
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