NPIMap

Organization Active NPI

Pinecrest Developmental Center

  • Developmentally Disabled Services Day Training Agency
  • Pineville, LA
National Provider Identifier
1114143674
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
ADC 9419 Issued in LA
Legal business name
PINECREST DEVELOPMENTAL CENTER
Practice address
2969 Highway 28 E
Pineville, LA 71360-5716
Phone
(318) 641-2000
NPI assigned
Apr 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Sherri A Evans
Title
Mr DD Regional Administrator
Phone
(318) 641-2003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X ADC 9419 LA Primary

Addresses

Primary practice location

2969 Highway 28 E
Pineville, LA 71360-5716

Mailing address

PO Box 5191
Pineville, LA 71361-5191
Phone (318) 641-2000

Other identifiers 1

IdentifierTypeStateIssuer
1157597MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Pinecrest Developmental Center19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114143674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5191",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713615191",
            "telephone_number": "318-641-2000",
            "fax_number": "318-641-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2969 HIGHWAY 28 E",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713605716",
            "telephone_number": "318-641-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MR DD REGIONAL ADMINISTRATOR",
        "authorized_official_telephone_number": "318-641-2003",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "LA",
            "license": "ADC 9419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1157597",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.