NPIMap

Organization Active NPI

360 Recovery Group LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baton Rouge, LA
National Provider Identifier
1033738562
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
360 RECOVERY GROUP LLC
Practice address
6220 Florida Blvd Ste D
Baton Rouge, LA 70806-4556
Phone
(225) 810-3885
Fax
(833) 810-3885
NPI assigned
Apr 14, 2020
Last updated
Jul 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Jaliah PabonNPI 1477280162
Title
Administrator
Phone
(225) 810-3885

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

6220 Florida Blvd Ste D
Baton Rouge, LA 70806-4556

Mailing address

6220 Florida Blvd Ste D
Baton Rouge, LA 70806-4556
Phone (225) 810-3885

Other names 1

  • NA Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200528002125 LA Part A Provider - Community Mental Health Center 5991126047 Practice locations: Baton Rouge, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033738562. Details of each certification follow.

  • CCN 194735 Community mental health center · Active · Name & address match · Details

Community mental health center certification: CCN 194735

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
360 RECOVERY GROUP, LLC
Certification status
Active
Provider type (POS)
Community mental health center
Participating since
Jul 27, 2022
Last certification
Jul 27, 2022
Ownership / control type
For profit – individual
Facility address
6220 Florida Blvd, Suite D
Baton Rouge, LA 70806

National Provider Directory

National Provider Directory

Locations

6220 Florida Blvd
Ste D
Baton Rouge, LA 70806
Phone (225) 810-0058

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1033738562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 FLORIDA BLVD STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708064556",
            "telephone_number": "225-810-3885",
            "fax_number": "833-810-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 FLORIDA BLVD STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708064556",
            "telephone_number": "225-810-3885",
            "fax_number": "833-810-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 RECOVERY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-14",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "PABON",
        "authorized_official_first_name": "JALIAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "225-810-3885"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.