Organization Active NPI

Colwell Interest, Inc.

Doing business as Poland Community Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Alexandria, LA
National Provider Identifier
1407042567
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
485 Issued in LA
Legal business name
COLWELL INTEREST, INC.
Doing business as
Poland Community Home
Practice address
3004 Highway 457
Alexandria, LA 71302-9255
Phone
(318) 442-5266
Fax
(318) 442-5266
NPI assigned
Sep 21, 2007
Last updated
Apr 9, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
COLWELL INTEREST, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Authorized official

Name
Mr. James B. Colwell
Title
Program Manager
Phone
(318) 442-2284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 485 LA Primary

Addresses

Primary practice location

3004 Highway 457
Alexandria, LA 71302-9255

Mailing address

1111 Main St
Pineville, LA 71360-6423
Phone (318) 442-2284

Other identifiers 1

IdentifierTypeStateIssuer
1717169MedicaidLA

Other names 1

  • Poland Community Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pineville Adult Day Care10 organizations share this tax ID, including this one
Part of
Pineville Adult Day Care

Other organizations with this tax ID 9

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

Locations

3004 Highway 457
Alexandria, LA 71302
Phone (318) 442-5266

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1407042567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MAIN ST",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713606423",
            "telephone_number": "318-442-2284",
            "fax_number": "318-448-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 HIGHWAY 457",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713029255",
            "telephone_number": "318-442-5266",
            "fax_number": "318-442-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLWELL INTEREST, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLWELL INTEREST, INC.",
        "enumeration_date": "2007-09-21",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "COLWELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "318-442-2284",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1717169",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poland Community Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.