Organization · Type 2 NPI
Provincial Community Home Inc
Intellectual Disabilities Intermediate Care Facility · Mansfield, LA
NPI number
1780894477
Active
Practice location
167 Poole Road
Mansfield, LA 71052-5007
Fax (318) 872-8833
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 636 (LA) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
Other intellectual disabilities intermediate care facility providers in Mansfield
About NPI 1780894477
Provincial Community Home Inc's National Provider Identifier is 1780894477, issued on May 23, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Mansfield, LA. The record was last updated on Aug 22, 2020.