NPIMap

Organization Active NPI

Mind Rehabilitation & Resource Center

  • Community/Behavioral Health Agency
  • Shreveport, LA
National Provider Identifier
1144674698
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MIND REHABILITATION & RESOURCE CENTER
Practice address
1513 Line Ave # 135
Shreveport, LA 71101-4621
Phone
(318) 828-1455
Fax
(318) 828-1626
NPI assigned
Apr 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Authorized official

Name
Latoyta Danielle Mandosia
Title
MHS
Phone
(318) 828-1455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LA Primary

Addresses

Primary practice location

1513 Line Ave # 135
Shreveport, LA 71101-4621

Mailing address

1513 Line Ave # 135
Shreveport, LA 71101-4621
Phone (318) 828-1455

Other names 1

  • Mind Rehabilitation & Resource Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Mind Rehabilitation Resource Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1144674698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 LINE AVE # 135",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014621",
            "telephone_number": "318-828-1455",
            "fax_number": "318-828-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 LINE AVE # 135",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014621",
            "telephone_number": "318-828-1455",
            "fax_number": "318-828-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND REHABILITATION & RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-21",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "MANDOSIA",
        "authorized_official_first_name": "LATOYTA",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "MHS",
        "authorized_official_telephone_number": "318-828-1455"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mind Rehabilitation & Resource Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 21, 2016; 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.