Polk Group Home
NPI #1447275011 in Alexandria, Louisiana
Provider Information
- NPI Number
- 1447275011
- Entity Type
- Organization
- Organization Name
- Polk Group Home
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- WESTSIDE HABILITATION CENTER INC
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Jul 13, 2006
- Last Updated
- Nov 7, 2009
Practice Location
- Address
- 557 MCKEITHEN DRIVE
- City
- Alexandria
- State
- Louisiana
- ZIP Code
- 71303
- Phone
- (318) 473-0212
Authorized Official
- Name
- MS. CHRISTINA BONNETTE BOLTON
- Title
- ADMINISTRATOR
- Phone
- (318) 445-1551
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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