Provincial Community Home Inc
Provincial Community Home Inc is an Intellectual Disabilities Intermediate Care Facility in Mansfield, Louisiana. Licensed in Louisiana. Registered with an NPI since 2007.
- Licensed in
- LA
- In the registry since
- 2007
What do these letters mean?
- Inc — Incorporated
- A form of business registration, not a clinical qualification.
Practice location Address checks out
416 Gibbs StMansfield, LA 71052-2618
Phone: (318) 872-6817
Fax: (318) 872-8833
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual Disabilities Intermediate Care Facility (primary) | Taxonomy 315P00000X · Licence 659 (LA) |
|---|
Record details
| NPI number | 1659581379 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Johnny Terrell — Administrator · (318) 872-0206 |
| Other names | Gibbs Street Community Home |
| NPI enumerated | May 23, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 416 Gibbs Street, Mansfield, LA 71052-2618 |
Other providers in Mansfield
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Provincial Community Home Inc
167 Poole Rd, Mansfield, LA 71052-5007 · (318) 872-0206