NPIMap

Organization Active NPI

G B Cooley-Willow Group Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • West Monroe, LA
National Provider Identifier
1427299767
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
1049 Issued in LA
Legal business name
G B COOLEY-WILLOW GROUP HOME
Practice address
364 GB Cooley Rd
West Monroe, LA 71291-8866
Phone
(318) 396-6300
Fax
(318) 396-7663
NPI assigned
Mar 17, 2009
Last updated
Nov 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Authorized official

Name
Ted Calloway
Title
Cfo
Phone
(318) 396-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 1049 LA Primary

Addresses

Primary practice location

364 GB Cooley Rd
West Monroe, LA 71291-8866

Mailing address

211 N 3Rd St
Monroe, LA 71201-6731
Phone (318) 396-3000

Other identifiers 1

IdentifierTypeStateIssuer
1049MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
G B Cooley Services Garrett29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1427299767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N 3RD ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712016731",
            "telephone_number": "318-396-3000",
            "fax_number": "318-396-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 GB COOLEY RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712918866",
            "telephone_number": "318-396-6300",
            "fax_number": "318-396-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G B COOLEY-WILLOW GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "CALLOWAY",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "318-396-6300"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "1049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1049",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.