Provider Demographics
NPI:1760871206
Name:WILLIAMS COMMUNITY CARE
Entity Type:Organization
Organization Name:WILLIAMS COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIERANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:251-454-1727
Mailing Address - Street 1:16441 S HARRELLS FERRY RD
Mailing Address - Street 2:5804
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-3599
Mailing Address - Country:US
Mailing Address - Phone:251-454-1727
Mailing Address - Fax:
Practice Address - Street 1:16441 S HARRELLS FERRY RD
Practice Address - Street 2:5804
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-3599
Practice Address - Country:US
Practice Address - Phone:251-454-1727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities