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NPI Code Detail

MEDICARE: ST MARYS RESD TRAINING SCHOOL

MEDICARE: ST MARYS RESD TRAINING SCHOOL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1315P00000XIntellectual Disabilities Intermediate Care Facility928LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568656379
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST MARYS RESD TRAINING SCHOOL
Provider Business Mailing Address
First Line : PO DRAWER 7768
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71306
Country : US
Telephone Number : 318-445-6443
Fax Number : 318-449-8520
Provider Business Practice Location Address
First Line : 6725 HWY 1 NORTH
Second Line :
City : BOYCE
State : LA
Zip : 71409
Country : US
Telephone Number : 318-443-9372
Fax Number :
Authorized Official
Title or Position : ADMINISTRATIVE SERVICE DIRECTOR
Name : MRS. CHRISTI GUILLOT
Credential :
Telephone Number : 318-445-6443
Provider Enumeration Date : 09/05/2007
Last Update Date : 09/05/2007

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Directions to “ST MARYS RESD TRAINING SCHOOL ” Practice Location

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