NPIMap

Organization Active NPI

St. Genevive Health Care Services, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Shreveport, LA
National Provider Identifier
1154547578
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
RC 7049 Issued in LA
Legal business name
ST. GENEVIVE HEALTH CARE SERVICES, INC.
Practice address
3003 Knight St
Suite 123
Shreveport, LA 71105-2507
Phone
(318) 219-4101
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Tina Graham
Title
Director
Phone
(318) 219-4101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X RC 7049 LA Primary

Addresses

Primary practice location

3003 Knight St
Suite 123
Shreveport, LA 71105-2507

Mailing address

6009 Financial PLZ Ste 101
Shreveport, LA 71129-2615
Phone (318) 221-2566

Other identifiers 1

IdentifierTypeStateIssuer
1505480MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
St Genevive Health Care Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1154547578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6009 FINANCIAL PLZ STE 101",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711292615",
            "telephone_number": "318-221-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 KNIGHT ST",
            "address_2": "SUITE 123",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052507",
            "telephone_number": "318-219-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. GENEVIVE HEALTH CARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "318-219-4101"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "RC 7049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1505480",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 15, 2024; 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.