NPIMap

Organization Active NPI

Intensive Specialty Hospital, LLC

Doing business as Intensive Behavioral Health

  • Psychiatric Hospital Unit
  • Shreveport, LA
National Provider Identifier
1316522774
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
INTENSIVE SPECIALTY HOSPITAL, LLC
Doing business as
Intensive Behavioral Health
Practice address
1800 Irving PL
Shreveport, LA 71101-4608
Phone
(318) 934-0539
Fax
(318) 656-5353
NPI assigned
Mar 16, 2021
Last updated
Oct 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Authorized official

Name
Chaim Rottenberg
Title
Asset Manager
Phone
(347) 522-5970

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Psychiatric Hospital Unit 273R00000X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

1800 Irving PL
Shreveport, LA 71101-4608

Mailing address

150 Airport Rd Ste 900
Lakewood, NJ 08701-6988
Phone (516) 668-9675

Other names 1

  • Intensive Behavioral Health Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://intensivespecialty.sharepoint.com/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200612002217 LA Part A Provider - Hospital 6507196995 1 other NPI on this enrollment
Practice locations: Shreveport, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316522774. Details of each certification follow.

Hospital certification: CCN 19SA10

Legal name
INTENSIVE SPECIALTY HOSPITAL, LLC
Organization structure
LLCProprietary
Incorporated
Mar 19, 2019 in LA
Enrollment address
1800 Irving PL
Shreveport, LA 71101-4608
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Other NPIs with the same Medicare PAC ID 2

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
Tax ID family
Intensive Specialty Hospital LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

8001 Youree Dr
Fl 8
Shreveport, LA 71115
Phone (318) 425-4096

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Chaim Rottenberg Individual 5% Or Greater Direct Ownership InterestOwner Sep 1, 2019 100%
W-2 Managing EmployeeAsset Manager Aug 31, 2019
Operational/Managerial ControlAsset Manager Aug 31, 2019 100%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Intensive Specialty Hospital, LLCBossier City, LA, CCN 192010 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 31, 2019
Aug 31, 2019

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

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": "1615852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1316522774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 AIRPORT RD STE 900",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087016988",
            "telephone_number": "516-668-9675",
            "fax_number": "732-370-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 IRVING PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014608",
            "telephone_number": "318-934-0539",
            "fax_number": "318-656-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENSIVE SPECIALTY HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-16",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "ROTTENBERG",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "ASSET MANAGER",
        "authorized_official_telephone_number": "347-522-5970"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://intensivespecialty.sharepoint.com/",
            "affiliation": "N",
            "address_1": "1800 Irving Pl",
            "city": "Shreveport",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711014608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Intensive Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intensive Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.