The Guest House LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

870 Issued in LA

Legal business name

THE GUEST HOUSE LLC

Practice address

9225 Normandie Dr
Shreveport, LA 71118-3249

Phone

(318) 686-0515

Fax

(318) 687-0311

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kevin C Gamble

Title

Officer

Phone

(318) 798-2648

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1073555652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52389",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711352389",
            "telephone_number": "318-798-2648",
            "fax_number": "318-798-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9225 NORMANDIE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183249",
            "telephone_number": "318-686-0515",
            "fax_number": "318-687-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GUEST HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "318-798-2648",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518221",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• The Kennedy Center of Louisiana

• Skilled Nursing Facility in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Skilled Nursing Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; 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.