NPIMap

Organization Active NPI

Pinecrest Developmental Center

Doing business as Pinecrest Supports and Services Center

  • Early Intervention Provider Agency
  • Pineville, LA
National Provider Identifier
1316198575
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
PINECREST DEVELOPMENTAL CENTER
Doing business as
Pinecrest Supports and Services Center
Practice address
100 Pinecrest Dr
Pineville, LA 71360-4276
Phone
(318) 641-2115
Fax
(318) 641-2309
NPI assigned
Oct 7, 2008
Last updated
Dec 8, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
PINECREST DEVELOPMENTAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

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

Authorized official

Name
Sherri A. Evans
Title
Regional Administrator
Phone
(318) 641-2006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

100 Pinecrest Dr
Pineville, LA 71360-4276

Mailing address

PO Box 5191
Pineville, LA 71361-5191
Phone (318) 641-2115

Other names 1

  • Pinecrest Supports and Services Center Doing business as

Medicare participation

Medicare enrollment files
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 1316198575. Details of each certification follow.

  • CCN 19G007 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 19G007

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Pinecrest Supports and Services Center
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Sep 23, 1982
Last certification
May 13, 2025
Beds
1,222
Ownership / control type
State
Facility address
100 Pinecrest Drive
Pineville, LA 71360

National Provider Directory

National Provider Directory
Tax ID family
Pinecrest Supports and Services Center19 organizations share this tax ID, including this one
Part of
Pinecrest Supports and Services Center

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1316198575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5191",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713615191",
            "telephone_number": "318-641-2115",
            "fax_number": "318-641-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PINECREST DR",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604276",
            "telephone_number": "318-641-2115",
            "fax_number": "318-641-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST DEVELOPMENTAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINECREST DEVELOPMENTAL CENTER",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "REGIONAL ADMINISTRATOR",
        "authorized_official_telephone_number": "318-641-2006"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinecrest Supports and Services Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pineville, LA

Sources for this page

Verify at the official NPI Registry.