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Organization

RAPIDES GROUP HOME

Active
Parent organization
WESTSIDE HABILITATION CENTER, INC.
Other names
Westside Habilitation Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
WESTSIDE HABILITATION CENTER, INC.
Authorized official
MS. CHRISTINA BONNETTE BOLTON (ADMINISTRATOR)
(318) 445-1551
Entity
Organization

Contact information

Practice address
207 THIRD STREET, CHENEYVILLE, LA 71325
(318) 279-2151
(318) 279-2152
Mailing address
PO BOX 7917, ALEXANDRIA, LA 71306-0917
(318) 445-1551
(318) 445-1242

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
764
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1713201
UNISYS
LA
Enumeration date
07/17/2006
Last updated
11/06/2009
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