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POLK GROUP HOME

Intermediate Care Facility, Mentally Retarded

Alexandria, Louisiana

Provider NPI: 1447275011

Organization Information:
Organization Name:  POLK GROUP HOME


Practice Location:
557 MCKEITHEN DRIVE  ALEXANDRIA, LA 71303 US
Tel: 318-473-0212  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
LA815

Other Provider Identifiers:

IssuerNumberStateType
UNISYS1713678LA01
19G531LA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS LA - Page 1



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