Organization · Type 2 NPI

Upgrade Group Home LLC

Emotionally Disturbed Childrens' Residential Treatment Facility · Baton Rouge, LA

NPI number 1306481445 Active

Practice location

3719 Katherine Ave, 3719 Katherine Ave
Baton Rouge, LA 70805

Specialties and licenses

Taxonomy	Code	License
Emotionally Disturbed Childrens' Residential Treatment Facility Primary	322D00000X	None listed

Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

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NPI record

NPI: 1306481445
Entity type: Organization (Type 2)
Issued: Nov 13, 2019
Last updated: Nov 13, 2019
Status: Active

Other names

Upgrade Group Home LLC · former legal business name
Upgrade Group Home, LLC · former legal business name

Authorized official

Dr. Carl Williams
DR of Theology
(225) 394-9271

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About NPI 1306481445

Upgrade Group Home LLC's National Provider Identifier is 1306481445, issued on Nov 13, 2019. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Baton Rouge, LA. The record was last updated on Nov 13, 2019.