Provider Demographics
NPI:1417352428
Name:WE CARE RESIDENTIAL SERVICES, LLC
Entity Type:Organization
Organization Name:WE CARE RESIDENTIAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SIBAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:318-619-2992
Mailing Address - Street 1:1404 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-7933
Mailing Address - Country:US
Mailing Address - Phone:318-619-2992
Mailing Address - Fax:318-619-2993
Practice Address - Street 1:1404 5TH ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-7933
Practice Address - Country:US
Practice Address - Phone:318-619-2992
Practice Address - Fax:318-619-2993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203782155320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness