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Allen Parish Hospital District No 3

Organization Active NPI Home Health Agency · Kinder, LA

NPI 1508917154 · NPPES record last updated Apr 30, 2026

Key facts

NPI
1508917154
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
820 (LA)
Legal business name
ALLEN PARISH HOSPITAL DISTRICT NO 3
Practice address
108 Sixth Ave
Kinder, LA 70648-1670
Phone
(337) 738-5627
Fax
(337) 738-4007
NPI assigned
Jan 12, 2007
Organization subpart
No

Authorized official

Name
Jacqueline Rae Costley-Reviel
Title
Ceo
Phone
(337) 738-2527

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 7

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

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 49

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Home health agency

Listed as
Allen Parish Home Health CCN 197748
Overall star rating
★★☆☆☆ 2 of 5
Ownership
Government Operated
Certified
Oct 27, 1995
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D0903842Allen Parish Home Health
108 6TH Avenue, Kinder, LA 70648		Certificate of waiverJul 30, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Home health agency certification: CCN 197748

Legal name
ALLEN PARISH HOSPITAL DISTRICT NO 3
Doing business as
ALLEN PARISH HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 27, 1995
Last certification
Mar 12, 2019
Ownership / control type
Government Operated
Organization structure
Other · Non-profit
Incorporated
Jul 23, 1969 in LA
Enrollment address
532 N 8TH St
Kinder, LA 70648-3323

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Melissa Martin
Individual 		W-2 Managing Employee
Director of Finance		 May 19, 2008
Allen Parish Hospital District No 3
Organization
Non-profit 		Other Dec 27, 1995 100%
Jacqueline Reviel
Individual 		W-2 Managing Employee Sep 25, 2014
Richard Stokes
Individual 		W-2 Managing Employee Aug 1, 2023

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Allen Parish Hospital Rural Health Clinic
Kinder, LA · CCN 193470		 Rural health clinic Other (100%) Apr 14, 1966

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120418000819 LA Part a Provider - Home Health Agency 3274431341 Practice locations: Kinder, LA

National Provider Directory

Tax ID family
Khudr Burjak MD (8 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 820 LA Yes

Addresses

Primary practice location

108 Sixth Ave
Kinder, LA 70648-1670

Mailing address

108 6TH Ave
Kinder, LA 70648-3187
Phone (337) 738-5627

Other identifiers

IdentifierTypeStateIssuer
1406554MedicaidLA
30011OtherLABCBS PROVIDER NUMBER

Other names

  • Allen Parish Home Health Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address ehr-direct@aph.hin.us Direct

Other providers in Kinder, LA

All providers in Kinder, LA · Home Health Agency in Louisiana

Sources for this page

Verify at the official NPI Registry.