NPIMap

Organization Active NPI

Council for Advancement of Social Service and Education

Doing business as Casse/Community Health Institute

  • Federally Qualified Health Center (FQHC)
  • Mansfield, LA
National Provider Identifier
1285942284
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
104 Issued in LA
Legal business name
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION
Doing business as
Casse/Community Health Institute
Practice address
907 Polk St
Mansfield, LA 71052-2520
Phone
(318) 872-1015
Fax
(318) 872-1055
NPI assigned
Sep 24, 2010
Last updated
Jul 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Authorized official

Name
Mrs. Mary M. Chumley
Title
President / Executive Director
Phone
(318) 688-3394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 104 LA Primary

Addresses

Primary practice location

907 Polk St
Mansfield, LA 71052-2520

Mailing address

2120 Bert Kouns Industrial Loop
Suite E
Shreveport, LA 71118-3351
Phone (318) 688-3350

Other names 1

  • Casse/Community Health Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051129000114 LA Part B Supplier - Clinic/Group Practice 8022043710 Receives reassigned benefits from 18 practitioners
1 other NPI on this enrollment
Practice locations: Mansfield, LA; Shreveport, LA
O20110418000847 LA Part A Provider - Federally Qualified Health Center (FQHC) 8022043710 Practice locations: Mansfield, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285942284. Details of each certification follow.

Federally qualified health center certification: CCN 191883

Legal name
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION
Doing business as
CASSE COMMUNITY HEALTH INSTITUTE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 19, 2011
Last certification
Apr 19, 2011
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 23, 1996 in LA
Enrollment address
907 Polk St
Mansfield, LA 71052-2520

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

907 Polk St
Mansfield, LA 71052
Phone (318) 688-3350

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Edward G Chumley Individual W-2 Managing EmployeeDental Director Feb 13, 2006 100%
Mary M Chumley Individual Corporate OfficerPresident/Ceo Dec 23, 1996 100%
Council for Advancement of Social Service and Education Organization, Mansfield, LA Operational/Managerial Control Feb 13, 2006

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1285942284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "SUITE E",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183351",
            "telephone_number": "318-688-3350",
            "fax_number": "318-688-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 POLK ST",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "710522520",
            "telephone_number": "318-872-1015",
            "fax_number": "318-872-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "CHUMLEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT / EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "318-688-3394",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "LA",
            "license": "104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Casse/Community Health Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, LA

Sources for this page

Verify at the official NPI Registry.