Red River Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

701 Issued in LA

Legal business name

RED RIVER CENTER LLC

Practice address

3405 Mansfield Rd
Shreveport, LA 71103-4107

Phone

(318) 222-3100

Fax

(318) 222-3930

NPI assigned

Jun 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Edward Neal Killian

Title

Administrator

Phone

(318) 222-3100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Rose View Nursing Center Doing business as

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1487650198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 MANSFIELD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034107",
            "telephone_number": "318-222-3100",
            "fax_number": "318-222-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 MANSFIELD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034107",
            "telephone_number": "318-222-3100",
            "fax_number": "318-222-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED RIVER CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "KILLIAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "NEAL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-222-3100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520713",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNEMPLOYMENT INS.",
            "identifier": "3592138",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rose View Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Skilled Nursing Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.