Organization

Community Bridges South, Inc.

May also be knows as Braswell Lane Home

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

Legal Business Name

Community Bridges South, Inc.

Also Known As

Braswell Lane Home

NPI Number

1346376084

NPI Type

Organization

Enumeration Date

02/26/2007

Specialties

(Taxonomies)

Code

315P00000X

Primary Taxonomy

Yes

Licenses

State

Louisiana

License Number

1038

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 715
560 BRASWELL LANE

City

Ruston
Simsboro

State

LA
LA

Postal Code

71273-0715
71275

Country

US
US

Telephone Number

(318) 255-1937
(318) 255-1937

Authorized Official

Name

Mr. Mike Reynolds

Title or Position

CEO

Telephone Number

(318) 255-1937

Identifiers

Identifier

1710008

Identifier State

LA

Identifier Issuer

Unknown

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

Data last updated by provider on 08/22/2020

Provider Address