Organization · Type 2 NPI

ST Marys Resd Training School

Intellectual Disabilities Intermediate Care Facility · Boyce, LA

NPI number 1669666475 Active

Practice location

1701 Madeley Avenue
Boyce, LA 71409-9312

Call (318) 445-8717 Map

Mailing address

PO Drawer 7768
Alexandria, LA 71306

Specialties and licenses

Taxonomy	Code	License
Intellectual Disabilities Intermediate Care Facility Primary	315P00000X	996 (LA)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

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NPI record

NPI: 1669666475
Entity type: Organization (Type 2)
Issued: Sep 5, 2007
Last updated: Sep 5, 2007
Status: Active
Subpart: Yes of ST Marys Resd Training School

Other names

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MSGR Joseph M Susi Knights of Columbus Home · doing business as

Authorized official

Mrs. Christi Guillot
Administrative Service Director
(318) 445-6443

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1669666475

ST Marys Resd Training School's National Provider Identifier is 1669666475, issued on Sep 5, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Boyce, LA. The record was last updated on Sep 5, 2007.