Organization
PINECREST DEVELOPMENTAL CENTER
Active
Parent organization
PINECREST DEVELOPMENTAL CENTER
Other names
Central LA. Behavioral/Health Resource Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PINECREST DEVELOPMENTAL CENTER
Authorized official
MR. PAXTON E. OLIVER II M. S. (MR/DD REGIONAL ASSOC. ADMINISTRATOR)
(318) 487-5395
Entity
Organization
Contact information
Practice address
2006 GUS KAPLAN DR, ALEXANDRIA, LA 71301-3376
(318) 487-5395
(318) 487-5463
Mailing address
2006 GUS KAPLAN DR, ALEXANDRIA, LA 71301-3376
(318) 487-5395
(318) 487-5463
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
LA
Other
Enumeration date
07/16/2010
Last updated
07/16/2010
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