NPIMap

Organization Active NPI

Havens Gateway Personal Care Facility Inc

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Baton Rouge, LA
National Provider Identifier
1346409943
Registry record updated Nov 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X
License
RC 13015 Issued in LA
Legal business name
HAVENS GATEWAY PERSONAL CARE FACILITY INC
Practice address
1200 S Acadian Thruway
212
Baton Rouge, LA 70806-6900
Phone
(225) 343-4740
Fax
(225) 343-4742
NPI assigned
Jun 9, 2008
Last updated
Nov 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2008

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

Authorized official

Name
Mrs. Alfreda Carter Jackson, BA
Title
Director Administrator
Phone
(225) 343-4740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X RC 13015 LA Primary

Addresses

Primary practice location

1200 S Acadian Thruway
212
Baton Rouge, LA 70806-6900

Mailing address

1200 S Acadian Thruway
212
Baton Rouge, LA 70806-6900
Phone (225) 343-4740

Other identifiers 2

IdentifierTypeStateIssuer
RC 13015MedicaidLA
1072583MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Haven's Gateway Personal Care Facility 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": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1346409943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S ACADIAN THRUWAY",
            "address_2": "212",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708066900",
            "telephone_number": "225-343-4740",
            "fax_number": "225-343-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S ACADIAN THRUWAY",
            "address_2": "212",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708066900",
            "telephone_number": "225-343-4740",
            "fax_number": "225-343-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENS GATEWAY PERSONAL CARE FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ALFREDA",
        "authorized_official_middle_name": "CARTER",
        "authorized_official_title_or_position": "DIRECTOR ADMINISTRATOR",
        "authorized_official_telephone_number": "225-343-4740",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "LA",
            "license": "RC 13015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RC 13015",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1072583",
            "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 Nov 20, 2008; 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.