NPIMap

Organization Active NPI

Greater Fellowship Outreach Center, Inc

  • Attendant Care Provider
  • Baton Rouge, LA
National Provider Identifier
1316164536
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
License
7934 Issued in LA
Legal business name
GREATER FELLOWSHIP OUTREACH CENTER, INC
Practice address
11752 S Harrells Ferry Rd
Suite E
Baton Rouge, LA 70816-2387
Phone
(225) 292-9628
Fax
(225) 292-9623
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Keisha Daisy
Title
Owner-Director
Phone
(225) 292-9628

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care ProviderGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 3747A0650X 7934 LA Primary

Addresses

Primary practice location

11752 S Harrells Ferry Rd
Suite E
Baton Rouge, LA 70816-2387

Mailing address

11752 S Harrells Ferry Rd
Suite E
Baton Rouge, LA 70816-2387
Phone (225) 292-9628

Other identifiers 1

IdentifierTypeStateIssuer
1153915MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Greater Fellowship Outreach Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316164536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11752 S HARRELLS FERRY RD",
            "address_2": "SUITE E",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162387",
            "telephone_number": "225-292-9628",
            "fax_number": "225-292-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11752 S HARRELLS FERRY RD",
            "address_2": "SUITE E",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162387",
            "telephone_number": "225-292-9628",
            "fax_number": "225-292-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER FELLOWSHIP OUTREACH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAISY",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "OWNER-DIRECTOR",
        "authorized_official_telephone_number": "225-292-9628"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": "LA",
            "license": "7934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1153915",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.