NPIMap

Organization Active NPI

Peach Community Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Alexandria, LA
National Provider Identifier
1609177757
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
16667 Issued in LA
Legal business name
PEACH COMMUNITY HOME
Practice address
528 Bob White LN
Alexandria, LA 71303-2415
Phone
(318) 787-6915
NPI assigned
Nov 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Authorized official

Name
Ms. Kara Henry Bertrand
Title
Administrator
Phone
(318) 448-0291

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 16667 LA Primary

Addresses

Primary practice location

528 Bob White LN
Alexandria, LA 71303-2415

Mailing address

528 Bob White LN
Alexandria, LA 71303-2415
Phone (318) 787-6915

National Provider Directory

National Provider Directory
Tax ID family
Peach Community Home4 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": "1288915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1609177757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 BOB WHITE LN",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032415",
            "telephone_number": "318-787-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 BOB WHITE LN",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032415",
            "telephone_number": "318-787-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH COMMUNITY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "BERTRAND",
        "authorized_official_first_name": "KARA",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-448-0291",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "16667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.