NPIMap

Organization Active NPI

Diversified Healthcare Slidell LLC Dba Northshore Living Center

  • Skilled Nursing Facility
  • Slidell, LA
National Provider Identifier
1629007497
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
925 Issued in LA
Legal business name
DIVERSIFIED HEALTHCARE SLIDELL LLC DBA NORTHSHORE LIVING CENTER
Practice address
106 Medical Center Dr
Slidell, LA 70461-5575
Phone
(985) 643-0307
Fax
(985) 641-9307
NPI assigned
Jul 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Tracy Hauver, D.O.
Title
Director of Operations
Phone
(985) 643-0307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 925 LA Primary

Addresses

Primary practice location

106 Medical Center Dr
Slidell, LA 70461-5575

Mailing address

106 Medical Center Dr
Slidell, LA 70461-5575
Phone (985) 643-0307

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629007497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MEDICAL CENTER DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615575",
            "telephone_number": "985-643-0307",
            "fax_number": "985-641-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MEDICAL CENTER DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615575",
            "telephone_number": "985-643-0307",
            "fax_number": "985-641-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED HEALTHCARE SLIDELL LLC DBA NORTHSHORE LIVING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAUVER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "985-643-0307",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.