NPIMap

Organization Active NPI

Holy Angels Residential Facility

Doing business as AngelWorks Pre-Vocational Training

  • Developmentally Disabled Services Day Training Agency
  • Shreveport, LA
National Provider Identifier
1124578174
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
82511 Issued in LA
Legal business name
HOLY ANGELS RESIDENTIAL FACILITY
Doing business as
AngelWorks Pre-Vocational Training
Practice address
10450 Ellerbe Rd
Shreveport, LA 71106-7712
Phone
(318) 797-8500
Fax
(318) 797-0801
NPI assigned
Oct 13, 2016
Last updated
May 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Authorized official

Name
Chris L Horne, CPA
Title
Director of Finance
Phone
(187) 978-5003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 82511 LA Primary

Addresses

Primary practice location

10450 Ellerbe Rd
Shreveport, LA 71106-7712

Mailing address

10450 Ellerbe Rd
Shreveport, LA 71106-7712
Phone (318) 797-8500

Other identifiers 16

IdentifierTypeStateIssuer
1346469012MedicaidLA
1619196383MedicaidLA
1184843849MedicaidLA
1225256038MedicaidLA
1316165418MedicaidLA
1437378106MedicaidLA
1578014387MedicaidLA
1770750747MedicaidLA
1164641833MedicaidLA
1639345853MedicaidLA
1861747638MedicaidLA
1992924658MedicaidLA
1073732749MedicaidLA
1497173090MedicaidLA
1528287299MedicaidLA
1982823654MedicaidLA

Other names 1

  • AngelWorks Pre-Vocational Training Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Holy Angels Residential Facility23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1124578174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 ELLERBE RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067712",
            "telephone_number": "318-797-8500",
            "fax_number": "318-797-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 ELLERBE RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067712",
            "telephone_number": "318-797-8500",
            "fax_number": "318-797-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY ANGELS RESIDENTIAL FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "HORNE",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "187-978-5003",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "LA",
            "license": "82511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346469012",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619196383",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184843849",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225256038",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316165418",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437378106",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578014387",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770750747",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164641833",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639345853",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861747638",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992924658",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073732749",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497173090",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528287299",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982823654",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AngelWorks Pre-Vocational Training",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AngelWorks Pre-Vocational Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.