NPIMap

Organization Active NPI

Provision Rehab

  • Community/Behavioral Health Agency
  • Natchitoches, LA
National Provider Identifier
1154879039
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PROVISION REHAB
Practice address
113 Bienville SQ
Natchitoches, LA 71457-5069
Phone
(318) 238-4030
NPI assigned
Sep 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Authorized official

Name
Deadrian Ficklin
Title
Director
Phone
(318) 238-4030

Specialties & licenses 1

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

Addresses

Primary practice location

113 Bienville SQ
Natchitoches, LA 71457-5069

Mailing address

113 Bienville SQ
Natchitoches, LA 71457-5069
Phone (318) 238-4030

National Provider Directory

National Provider Directory

Locations

113 Bienville Sq
Natchitoches, LA 71457
Phone (318) 238-4030

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1154879039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 BIENVILLE SQ",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575069",
            "telephone_number": "318-238-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 BIENVILLE SQ",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575069",
            "telephone_number": "318-238-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "FICKLIN",
        "authorized_official_first_name": "DEADRIAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "318-238-4030"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchitoches, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.