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Holy Angels Residential Facility
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Shreveport, Louisiana
NPI 1861747636

Holy Angels Residential Facility is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Shreveport, LA. Holy Angels Residential Facility practices in Shreveport, LA. The NPI Number for Holy Angels Residential Facility is 1861747636 and holds a License No. (Louisiana).

The current practice location address for Holy Angels Residential Facility is 10450 Ellerbe Rd, Shreveport, LA and can be reached out via phone at 318-797-8500. You can also correspond with Holy Angels Residential Facility through the mailing address at 10450 ELLERBE RD, SHREVEPORT, LA - 71106-7712 (mailing address contact number: 318-797-8500).

Location: 10450 Ellerbe Rd, Shreveport, LA, 71106-7712
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1861747636
Provider Name
Holy Angels Residential Facility
Credential
Provider Entity Type
Organization
Address
10450 Ellerbe Rd, Shreveport, LA, 71106-7712
Phone Number
318-797-8500
Fax Number
Provider Enumeration Date
07/18/2012
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6671 01 LA DHH STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
10450 Ellerbe Rd
City
Shreveport
State
Louisiana
Zip
71106-7712
Phone Number
318-797-8500
Fax Number
person
Provider Business Mailing Address Details
Address
10450 Ellerbe Rd
City
Shreveport
State
Louisiana
Zip
71106-7712
Phone Number
318-797-8500
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
6671 (Louisiana)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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