Upgrade Group Home LLC

NPI #1306481445 in Baton Rouge, Louisiana

Provider Information

NPI Number: 1306481445
Entity Type: Organization
Organization Name: Upgrade Group Home LLC
Primary Specialty: Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date: Nov 13, 2019
Last Updated: Nov 13, 2019

Practice Location

Address: 3719 KATHERINE AVE
Address 2: 3719 KATHERINE AVE
City: Baton Rouge
State: Louisiana
ZIP Code: 70805
Phone: (225) 394-9271

Authorized Official

Name: DR. CARL WILLIAMS
Title: DR OF THEOLOGY
Phone: (225) 394-9271

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X	Primary

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