NPIMap

Organization Active NPI

Edgefield Recovery Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Cheneyville, LA
National Provider Identifier
1245468826
Registry record updated Jun 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
448 Issued in LA
Legal business name
EDGEFIELD RECOVERY CENTER, LLC
Practice address
10631 Hwy 71 South
Cheneyville, LA 71325
Phone
(318) 279-2751
Fax
(318) 279-2755
NPI assigned
Jun 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2009

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

Authorized official

Name
Mr. Tom Brennan
Title
Coo
Phone
(318) 279-2751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 448 LA Primary

Addresses

Primary practice location

10631 Hwy 71 South
Cheneyville, LA 71325

Mailing address

PO Box 407
Cheneyville, LA 71325-0407
Phone (318) 279-2751

National Provider Directory

National Provider Directory
Tax ID family
Edgefield Recovery Center Dba Positive Direction Iop2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2321 Highway 80 E
Monroe, LA 71203
Phone (318) 600-3333

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

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": "1245715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245715200000",
    "number": "1245468826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "CHENEYVILLE",
            "state": "LA",
            "postal_code": "713250407",
            "telephone_number": "318-279-2751",
            "fax_number": "318-279-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10631 HWY 71 SOUTH",
            "city": "CHENEYVILLE",
            "state": "LA",
            "postal_code": "71325",
            "telephone_number": "318-279-2751",
            "fax_number": "318-279-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEFIELD RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-23",
        "last_updated": "2009-06-23",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "318-279-2751",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "LA",
            "license": "448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheneyville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; 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.