Organization Active NPI

First Chance Independent Living, Inc

  • Home Health Agency
  • Baton Rouge, LA
National Provider Identifier
1497930473
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
12021 Issued in LA
Legal business name
FIRST CHANCE INDEPENDENT LIVING, INC
Practice address
414 N Acadian Thruway
Baton Rouge, LA 70806-3260
Phone
(225) 383-1525
Fax
(225) 383-1521
NPI assigned
Jan 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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

Authorized official

Name
Johnny O'Neal Wallace
Title
President
Phone
(225) 383-1525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 12021 LA Primary

Addresses

Primary practice location

414 N Acadian Thruway
Baton Rouge, LA 70806-3260

Mailing address

414 N Acadian Thruway
Baton Rouge, LA 70806-3260
Phone (225) 383-1525

Other identifiers 2

IdentifierTypeStateIssuer
1465020MedicaidLA
1469718MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
First Chance Independent Living Inc4 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": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1497930473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 N ACADIAN THRUWAY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063260",
            "telephone_number": "225-383-1525",
            "fax_number": "225-383-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 N ACADIAN THRUWAY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063260",
            "telephone_number": "225-383-1525",
            "fax_number": "225-383-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHANCE INDEPENDENT LIVING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "O'NEAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-383-1525"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "LA",
            "license": "12021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1465020",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1469718",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.