NPIMap

Organization Active NPI

CDS Ashley Ridge

  • Community/Behavioral Health Agency
  • Shreveport, LA
National Provider Identifier
1235442419
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
316A Issued in LA
Legal business name
CDS ASHLEY RIDGE
Practice address
460 Ashley Ridge Blvd
Suite 200
Shreveport, LA 71106-7235
Phone
(318) 865-0039
Fax
(318) 865-1986
NPI assigned
Jul 16, 2010
Last updated
Jul 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Authorized official

Name
Mr. Robert Layne Bonvillain, LCSW
Title
Owner/Clinical Director
Phone
(318) 865-0039

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 316A LA Primary

Addresses

Primary practice location

460 Ashley Ridge Blvd
Suite 200
Shreveport, LA 71106-7235

Mailing address

460 Ashley Ridge Blvd
Suite 200
Shreveport, LA 71106-7235
Phone (318) 865-0039

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279238400000",
    "number": "1235442419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 ASHLEY RIDGE BLVD",
            "address_2": "SUITE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067235",
            "telephone_number": "318-865-0039",
            "fax_number": "318-865-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 ASHLEY RIDGE BLVD",
            "address_2": "SUITE 200",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067235",
            "telephone_number": "318-865-0039",
            "fax_number": "318-865-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDS ASHLEY RIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-07-16",
        "status": "A",
        "authorized_official_last_name": "BONVILLAIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LAYNE",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "318-865-0039",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "316A",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 16, 2010; 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.