NPIMap

Organization Active NPI

Holy Angels Residential Facility

Doing business as Holy Angels Autism Center

  • Behavior Analyst
  • Shreveport, LA
National Provider Identifier
1578014387
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
HOLY ANGELS RESIDENTIAL FACILITY
Doing business as
Holy Angels Autism Center
Practice address
10450 Ellerbe Rd
Shreveport, LA 71106-7712
Phone
(318) 797-8500
Fax
(318) 797-0801
NPI assigned
Oct 17, 2016
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
Mrs. Christina Landry Horne, CPA
Title
Director of Finance
Phone
(318) 797-8500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

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
2431641MedicaidLA

Other names 1

  • Holy Angels Autism Center Doing business as

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

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1578014387",
    "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": "318-797-0801"
        },
        {
            "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": "318-797-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY ANGELS RESIDENTIAL FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "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_name_prefix": "Mrs.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2431641",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holy Angels Autism Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Holy Angels Autism Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.