NPIMap

Organization Active NPI

Novice House of Baton Rouge, Inc.

  • Community/Behavioral Health Agency
  • Baton Rouge, LA
National Provider Identifier
1164748596
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
NOVICE HOUSE OF BATON ROUGE, INC.
Practice address
11616 Southfork Ave Ste 203
Baton Rouge, LA 70816-5241
Phone
(225) 291-9718
Fax
(225) 291-9692
NPI assigned
Apr 9, 2010
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
Ms. Antoinette M Clark
Title
Owner
Phone
(225) 923-1044

Specialties & licenses 1

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

Addresses

Primary practice location

11616 Southfork Ave Ste 203
Baton Rouge, LA 70816-5241

Mailing address

11616 Southfork Ave Ste 203
Baton Rouge, LA 70816-5241
Phone (225) 291-9718

Other identifiers 1

IdentifierTypeStateIssuer
600720433MedicaidLA

Other names 1

  • Family Services Unlimited, INC Doing business as

National Provider Directory

National Provider Directory

Locations

11616 Southfork Ave
Ste 203
Baton Rouge, LA 70816
Phone (225) 291-9646

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1164748596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11616 SOUTHFORK AVE STE 203",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708165241",
            "telephone_number": "225-291-9718",
            "fax_number": "225-291-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11616 SOUTHFORK AVE STE 203",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708165241",
            "telephone_number": "225-291-9718",
            "fax_number": "225-291-9692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVICE HOUSE OF BATON ROUGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-09",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ANTOINETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-923-1044",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600720433",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Services Unlimited, INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baton Rouge, 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.