Provider Demographics
NPI:1902026149
Name:THOMAS PLACE RECOVERY HOUSE
Entity Type:Organization
Organization Name:THOMAS PLACE RECOVERY HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:225-201-1955
Mailing Address - Street 1:1956 DALLAS DR STE 1
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-1432
Mailing Address - Country:US
Mailing Address - Phone:225-201-1955
Mailing Address - Fax:225-201-1966
Practice Address - Street 1:7207 DESIARD ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-3914
Practice Address - Country:US
Practice Address - Phone:318-342-8717
Practice Address - Fax:318-342-8716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1469173251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services