Endeavor Seniorcare Hospital, L.L.C.

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

ENDEAVOR SENIORCARE HOSPITAL, L.L.C.

Practice address

2106 Loop Rd
Winnsboro, LA 71295-3342

Phone

(601) 250-4815

NPI assigned

Mar 6, 2007

Last updated

Apr 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles Bates

Title

Manager

Phone

(601) 250-4815

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285764720. Details of each certification follow.

• CCN 194092 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 194092

Legal name

ENDEAVOR SENIORCARE HOSPITAL

Certification status

Terminated Voluntary: merger or closure, Jun 19, 2008

Provider type (POS)

Hospital – Psychiatric

Participating since

Aug 13, 2007

Last certification

Aug 13, 2007

Beds

13

Ownership / control type

Private (not for profit)

Facility address

2106 Loop Road
Winnsboro, LA 71295

Locations

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1285764720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 MARYLAND AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 LOOP RD",
            "city": "WINNSBORO",
            "state": "LA",
            "postal_code": "712953342",
            "telephone_number": "601-250-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDEAVOR SENIORCARE HOSPITAL, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "601-250-4815"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Christopher Dollar
• Tanya Evette Douglas, BACHELORS
• Kelsey Easterling
• Educational Advocacy Supports & Enterprises, LLC
• Joel Glen Eldridge, D.O.
• Brian T Enlow, PT
• Kimberly Erskin, LOTR
• Delynn Eubanks, RPH
• Kimberly R Fannin - Trisler, APRN
• FJ's Medical Transportation LLC

• Psychiatric Hospital in Winnsboro, LA
• Providers in Winnsboro, LA by specialty
• Psychiatric Hospital in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.