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General NPI Number Information
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NPI Number | 1346485562
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Entity Type | Organization
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Legal Business Name | LOUISIANA HOME, INC.
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 12/03/2008
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Provider Practice Location Address
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Address Line | 1950 WEBB STREET
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City | DETROIT
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State | MI
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Zip | 48206-1282
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Country | US
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Telephone | 313-868-8724
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Fax | 313-883-5023
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Provider Business Mailing Address
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Address Line | 1950 WEBB STREET
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City | DETROIT
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State | MI
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Zip | 48206-1282
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Country | US
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Telephone | 313-868-8724
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Fax | 313-883-5023
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. LILLIA ROSE DODSON
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Credential | B.A. BUSINESS ADMINI
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Telephone | 313-868-8724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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