NPIMap

Organization Active NPI

St. Angela Merici Foundation

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Vinton, LA
National Provider Identifier
1396956207
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
PCA 6705 Issued in LA
Legal business name
ST. ANGELA MERICI FOUNDATION
Practice address
1340 Horridge St
Vinton, LA 70668-4532
Phone
(337) 589-1919
Fax
(337) 589-6604
NPI assigned
May 24, 2007
Last updated
Mar 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Authorized official

Name
Mrs. Cotina Boudreaux
Title
Director
Phone
(337) 589-1919

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X ADC11233 LA
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X PCA 6705 LA Primary

Addresses

Primary practice location

1340 Horridge St
Vinton, LA 70668-4532

Mailing address

1340 Horridge St
Vinton, LA 70668-4532
Phone (337) 589-1919

Other identifiers 4

IdentifierTypeStateIssuer
1003081233MedicaidLA
1467627604MedicaidLA
1396956207MedicaidLA
1760657993MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
St Angela Merici Foundation4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1396956207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 HORRIDGE ST",
            "city": "VINTON",
            "state": "LA",
            "postal_code": "706684532",
            "telephone_number": "337-589-1919",
            "fax_number": "337-589-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 HORRIDGE ST",
            "city": "VINTON",
            "state": "LA",
            "postal_code": "706684532",
            "telephone_number": "337-589-1919",
            "fax_number": "337-589-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANGELA MERICI FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "BOUDREAUX",
        "authorized_official_first_name": "COTINA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "337-589-1919",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "LA",
            "license": "ADC11233",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "PCA 6705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003081233",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467627604",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396956207",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760657993",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinton, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.