NPIMap

Organization Active NPI

Compass Senior Care Hospital, LLC

  • Psychiatric Hospital
  • Jennings, LA
National Provider Identifier
1164410288
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
COMPASS SENIOR CARE HOSPITAL, LLC
Practice address
1 Hospital Dr
Suite 201
Jennings, LA 70546-3641
Phone
(337) 824-1558
Fax
(337) 824-1561
NPI assigned
Oct 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Authorized official

Name
Rusty Phillips, LCSWNPI 1639360126
Title
Administrator
Phone
(337) 824-1558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

1 Hospital Dr
Suite 201
Jennings, LA 70546-3641

Mailing address

1 Hospital Dr
Suite 201
Jennings, LA 70546-3641
Phone (337) 824-1558

Other identifiers 1

IdentifierTypeStateIssuer
1709590MedicaidLA

Other names 1

  • Compass Senior Care Hospital, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050523000157 LA Part A Provider - Hospital 3375584147 Practice locations: Rayne, LA; Lake Charles, LA; Jennings, LA

Hospital certification: CCN 194082

Legal name
COMPASS SENIOR CARE HOSPITAL LLC
Doing business as
COMPASS SENIOR CARE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Dec 15, 2005
Last certification
Jul 26, 2023
Beds
36
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
May 7, 2004 in LA
Enrollment address
1 Hospital Dr
Ste 201
Jennings, LA 70546-3641
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Compass Senior Care HospitalCCN 194082
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Locations

1710 Evangeline Hwy
Jennings, LA 70546
Phone (337) 514-7278

3451 5th Ave
Lake Charles, LA 70607
Phone (337) 263-0926

2021 Crowley Rayne Hwy
#3
Rayne, LA 70578
Phone (337) 514-7000

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Cullen Holdings LLC Organization, Crowley, LA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 31, 2015 100%
Lynn F Cullen Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2015 10%
Lisa Chachere Individual W-2 Managing Employee Jul 1, 2023
Mark J Cullen Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2015 71%
Corporate Officer Dec 31, 2015
W-2 Managing Employee Apr 25, 2005
Compass Health LLC Organization, Crowley, LA LLC Operational/Managerial Control Jan 1, 2010
Other Jan 1, 2010

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 6

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": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1164410288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "SUITE 201",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463641",
            "telephone_number": "337-824-1558",
            "fax_number": "337-824-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "SUITE 201",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463641",
            "telephone_number": "337-824-1558",
            "fax_number": "337-824-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS SENIOR CARE HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2020-11-25",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "RUSTY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "337-824-1558",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1709590",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compass Senior Care Hospital, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jennings, LA

Sources for this page

Verify at the official NPI Registry.