NPIMap

Organization Active NPI

Pinecrest Developmental Center

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Pineville, LA
National Provider Identifier
1366564163
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
991000271 Issued in LA
Legal business name
PINECREST DEVELOPMENTAL CENTER
Practice address
100 Pinecrest Drive
Pineville, LA 71360
Phone
(318) 641-2000
Fax
(318) 641-2300
NPI assigned
Apr 4, 2007
Last updated
Nov 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Authorized official

Name
Ms. Monica R Bryant
Title
Director of Fiscal Services
Phone
(318) 641-2216

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 991000271 LA Primary

Addresses

Primary practice location

100 Pinecrest Drive
Pineville, LA 71360

Mailing address

PO Box 5191
Pineville, LA 71361-5191
Phone (318) 641-2000

Other identifiers 1

IdentifierTypeStateIssuer
1712001MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Pinecrest Developmental Center19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 6

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1366564163",
    "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": "318-641-2000",
            "fax_number": "318-641-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PINECREST DRIVE",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "71360",
            "telephone_number": "318-641-2000",
            "fax_number": "318-641-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF FISCAL SERVICES",
        "authorized_official_telephone_number": "318-641-2216",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "991000271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1712001",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.