Organization Name: | G B COOLEY SERVICES/DAY HABILITATION |
NPI Number: | 1104090752 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JIMMY SANDERLIN (DIRECTOR OF FINANCE) |
Mailing Address: | 364 Gb Cooley Rd West Monroe |
State: | LA US |
Postal Code: | 712918866 |
Phone Number: | 3183966300 |
Fax Number: | 3183967663 |
NPI Enumeration Date: | 04/15/2008 |
NPI Last Update Date: | 04/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320600000X |
License Number: | ADC 9827 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |