NPIMap

Organization Active NPI

Body & Soul Services, Inc.

Doing business as Body & Soul Rehabilitation Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bastrop, LA
National Provider Identifier
1285193185
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BODY & SOUL SERVICES, INC.
Doing business as
Body & Soul Rehabilitation Services
Practice address
5743 Mer Rouge Rd
Bastrop, LA 71220-9765
Phone
(318) 283-3299
Fax
(318) 283-3298
NPI assigned
Mar 19, 2019
Last updated
Jun 27, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BODY & SOUL SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Derenda Flowers
Title
Cfo, VP
Phone
(318) 283-3299

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

5743 Mer Rouge Rd
Bastrop, LA 71220-9765

Mailing address

5743 Mer Rouge Rd
Bastrop, LA 71220-9765
Phone (318) 974-6035

Other names 1

  • Body & Soul Rehabilitation Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Body Soul Servicesinc6 organizations share this tax ID, including this one
Part of
Body Soul Servicesinc

Other organizations with this tax ID 5

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

Locations

511 Gunby Ave
Bastrop, LA 71220
Phone (318) 281-2410

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1285193185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5743 MER ROUGE RD",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712209765",
            "telephone_number": "318-974-6035",
            "fax_number": "318-515-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5743 MER ROUGE RD",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712209765",
            "telephone_number": "318-283-3299",
            "fax_number": "318-283-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY & SOUL SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BODY & SOUL SERVICES, INC.",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "FLOWERS",
        "authorized_official_first_name": "DERENDA",
        "authorized_official_title_or_position": "CFO, VP",
        "authorized_official_telephone_number": "318-283-3299"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Body & Soul Rehabilitation Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Body & Soul Rehabilitation Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bastrop, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.