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  5. Jefferson Group Home
Organization

Jefferson Group Home

Intellectual Disabilities Intermediate Care Facility in Alexandria, LA(View on Map)

Legal Business Name

Jefferson Group Home

NPI Number

1821130717

NPI Type

Organization

Enumeration Date

02/14/2007

Specialties

(Taxonomies)

Name

Intellectual Disabilities Intermediate Care Facility

Code

315P00000X

Primary Taxonomy

Yes

Licenses

State

Louisiana

License Number

946

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 7917
1109 PRESIDENTS DRIVE

City

Alexandria
Alexandria

State

LA
LA

Postal Code

71306-0917
71303

Country

US
US

Telephone Number

(318) 445-1551
(318) 473-2505

Authorized Official

Name

Ms. Christina Bolton

Title or Position

ADMINISTRATOR

Telephone Number

(318) 445-1551

Identifiers

Identifier

1507211
19G574

Identifier State

LA
LA

Identifier Issuer

UNISYS
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/07/2009

Provider Address

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Organization

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Organization

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Organization

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