Provider Demographics
NPI:1073732954
Name:CB'S PLACE GROUP HOME
Entity Type:Organization
Organization Name:CB'S PLACE GROUP HOME
Other - Org Name:HARMONY CENTER, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:COLLIS
Authorized Official - Middle Name:BENTON
Authorized Official - Last Name:TEMPLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:225-383-9139
Mailing Address - Street 1:1560 C B TEMPLE RD
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:LA
Mailing Address - Zip Code:70444-3005
Mailing Address - Country:US
Mailing Address - Phone:225-383-9139
Mailing Address - Fax:225-336-5431
Practice Address - Street 1:2736 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-2719
Practice Address - Country:US
Practice Address - Phone:225-383-9139
Practice Address - Fax:225-336-5431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1004320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities