Organization · Type 2 NPI
Tenth Street Community Home
Intellectual Disabilities Intermediate Care Facility · Lake Charles, LA
NPI number
1629282116
Active
Practice location
1800 10th St
Lake Charles, LA 70601-6532
Fax (337) 436-0250
Mailing address
200 Avenue C
Lake Charles, LA 70615-6816
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 748 (LA) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
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About NPI 1629282116
Tenth Street Community Home's National Provider Identifier is 1629282116, issued on May 10, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Lake Charles, LA. The record was last updated on Aug 22, 2020.