NPIMap

Organization Active NPI

Resthaven Nursing & Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Lake Charles, LA
National Provider Identifier
1003897158
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
149 Issued in LA
Legal business name
RESTHAVEN NURSING & REHABILITATION CENTER, LLC
Practice address
1103 W McNeese St
Lake Charles, LA 70605-5431
Phone
(337) 477-6300
Fax
(337) 477-7189
NPI assigned
Nov 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Teddy R. Price
Title
Owner/Managing Member
Phone
(318) 628-4116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 149 LA Primary

Addresses

Primary practice location

1103 W McNeese St
Lake Charles, LA 70605-5431

Mailing address

1103 W McNeese St
Lake Charles, LA 70605-5431
Phone (337) 477-6300

Other identifiers 1

IdentifierTypeStateIssuer
1517194MedicaidLA

Other names 1

  • Resthaven Nursing & Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110420000832 LA Part A Provider - Skilled Nursing Facility 5294910014 Practice locations: Lake Charles, LA

Skilled nursing facility certification: CCN 195414

Legal name
RESTHAVEN NURSING & REHABILITATION CENTER, LLC
Doing business as
RESTHAVEN NURSING & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jun 1, 1997
Last certification
Aug 20, 2024
Beds
162
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Central Management Company
Organization structure
LLCProprietary
Enrollment address
1103 West McNeese Street
Resthaven Nursing & Rehabilitation Center
Lake Charles, LA 70605-5431
Nursing home name
RESTHAVEN NURSING & REHAB CENTER, LLC
Affiliated entity
CENTRAL MANAGEMENT COMPANY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Resthaven Nursing & Rehab Center, LLCCCN 195414
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 1, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
162108.6 residents per day on average
Chain
Central Management Company21 facilities in the chain
Penalties (3 years)
1Fines totaling $34,369

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Freda Zimmerman Trust Organization, Winnfield, LA 5% Or Greater Direct Ownership Interest Jan 1, 1987 16.66%
Adp of the SNF Feb 1, 2001
Teddy D Price Individual Operational/Managerial Control Mar 1, 2025
Adp of the SNF Mar 1, 2025
Jeffrey Lee Cantrell Individual Adp of the SNF Oct 1, 2013
Organization, Lake Charles, LA LLC, Consulting firm Adp of the SNF Apr 6, 2025
Teddy R Price Individual 5% Or Greater Direct Ownership Interest Jan 1, 1987 16.67%
5% Or Greater Indirect Ownership Interest Jan 1, 1987 66.67%
Operational/Managerial ControlManaging Member of Management Co Jan 1, 1987 100%
Adp of the SNF Jan 1, 1987
Central Management Company, LLC Organization, Winnfield, LA LLC, Management services company, Chain home office Operational/Managerial Control Mar 1, 2016 100%
Adp of the SNF Mar 1, 2016
Organization, Lake Charles, LA LLC Adp of the SNF Apr 6, 2025
Individual Adp of the SNF Jan 1, 2010
Organization, Winnfield, LA LLC, Consulting firm Adp of the SNF May 27, 2025
Individual Adp of the SNF Jan 1, 2011
Individual Adp of the SNF Jun 1, 1996
Dawn Rogers Individual Adp of the SNF Mar 1, 1993
Sheila M Bolwahnn Individual Adp of the SNF Dec 1, 2008
James Shelton Individual Adp of the SNF Jul 23, 1990
Organization, Winnfield, LA LLC, Holding company Adp of the SNF Feb 1, 2001
Asima Naeem Individual Adp of the SNF Mar 26, 2025
Kisatchie Health, LLC Organization, Winnfield, LA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 1987 66.67%
Adp of the SNF Feb 1, 2001
Individual Adp of the SNF Jun 1, 1997
David P Heinen Individual Adp of the SNF Mar 26, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 23

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 23

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743465600000",
    "number": "1003897158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055431",
            "telephone_number": "337-477-6300",
            "fax_number": "337-477-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055431",
            "telephone_number": "337-477-6300",
            "fax_number": "337-477-7189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTHAVEN NURSING & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "TEDDY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER/MANAGING MEMBER",
        "authorized_official_telephone_number": "318-628-4116"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1517194",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Resthaven Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Resthaven Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.