NPIMap

Organization Active NPI

Holy Angels Residential Facility

Doing business as Smith Home

  • Intellectual Disabilities Intermediate Care Facility
  • Shreveport, LA
National Provider Identifier
1528287299
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
HOLY ANGELS RESIDENTIAL FACILITY
Doing business as
Smith Home
Practice address
10450 Ellerbe Rd
Shreveport, LA 71106-7712
Phone
(318) 797-8500
Fax
(318) 798-0159
NPI assigned
Apr 24, 2007
Last updated
May 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Authorized official

Name
Christina Landry Horne, CPA
Title
Director of Finance
Phone
(318) 797-8500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Intermediate Care Facility 310500000X 931 LA
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary

Addresses

Primary practice location

10450 Ellerbe Rd
Shreveport, LA 71106-7712

Mailing address

10450 Ellerbe Rd
Shreveport, LA 71106-7712
Phone (318) 797-8500

Other identifiers 1

IdentifierTypeStateIssuer
1711217MedicaidLA

Other names 1

  • Smith Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528287299. Details of each certification follow.

  • CCN 19G561 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 19G561

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Smith Home
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Apr 1, 2004
Last certification
Dec 17, 2025
Beds
8
Ownership / control type
Private (non-profit)
Facility address
10450 Ellerbe Road
Shreveport, LA 71106

National Provider Directory

National Provider Directory
Tax ID family
Holy Angels Residential Facility23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1528287299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 ELLERBE RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067712",
            "telephone_number": "318-797-8500",
            "fax_number": "318-798-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 ELLERBE RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067712",
            "telephone_number": "318-797-8500",
            "fax_number": "318-798-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY ANGELS RESIDENTIAL FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "HORNE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "LANDRY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "318-797-8500",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "LA",
            "license": "931",
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1711217",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smith Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.