NPIMap

Organization Active NPI

Louisiana Guest House, LLC

Doing business as Camelot of Broussard Assisted Living

  • Assisted Living Facility
  • Broussard, LA
National Provider Identifier
1396038667
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AC13262 Issued in LA
Legal business name
LOUISIANA GUEST HOUSE, LLC
Doing business as
Camelot of Broussard Assisted Living
Practice address
418 Albertson Pkwy
Broussard, LA 70518-4971
Phone
(337) 839-9005
Fax
(337) 837-9398
NPI assigned
May 19, 2011
Last updated
May 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Authorized official

Name
Nicole Howard
Title
Chief Operating Officer
Phone
(318) 641-3717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AC13262 LA Primary

Addresses

Primary practice location

418 Albertson Pkwy
Broussard, LA 70518-4971

Mailing address

4333 Shreveport Hwy
Pineville, LA 71360-3828
Phone (318) 445-6470

Other names 1

  • Camelot of Broussard Assisted Living Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Camelot of Broussard Assisted Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1305763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1396038667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4333 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713603828",
            "telephone_number": "318-445-6470",
            "fax_number": "318-641-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 ALBERTSON PKWY",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705184971",
            "telephone_number": "337-839-9005",
            "fax_number": "337-837-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA GUEST HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "318-641-3717"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "LA",
            "license": "AC13262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelot of Broussard Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broussard, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.