NPIMap

Organization Active NPI

Shekinah Glory

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Baton Rouge, LA
National Provider Identifier
1063609204
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
SIL 12514 Issued in LA
Legal business name
SHEKINAH GLORY
Practice address
3613 Government St
Baton Rouge, LA 70806-5721
Phone
(225) 346-5225
Fax
(225) 346-5224
NPI assigned
Oct 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Authorized official

Name
Mrs. Debra Denise Carter, COUNSELOR
Title
Pastor
Phone
(225) 346-5225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X SIL 12514 LA Primary

Addresses

Primary practice location

3613 Government St
Baton Rouge, LA 70806-5721

Mailing address

PO Box 53766
Baton Rouge, LA 70892-3766
Phone (225) 346-5225

Other identifiers 1

IdentifierTypeStateIssuer
1720828MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Shekinah Glory3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1063609204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53766",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708923766",
            "telephone_number": "225-346-5225",
            "fax_number": "225-346-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3613 GOVERNMENT ST",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708065721",
            "telephone_number": "225-346-5225",
            "fax_number": "225-346-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEKINAH GLORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "PASTOR",
        "authorized_official_telephone_number": "225-346-5225",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "COUNSELOR"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "SIL 12514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720828",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.