NPIMap

Organization Active NPI

G B Cooley Services South Grand

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Monroe, LA
National Provider Identifier
1629100862
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
373 Issued in LA
Legal business name
G B COOLEY SERVICES SOUTH GRAND
Practice address
2103 S Grand St
Monroe, LA 71202-2521
Phone
(318) 396-6300
Fax
(318) 396-3660
NPI assigned
Mar 12, 2007
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
Mr. Ben Pitts
Title
Ceo
Phone
(318) 396-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 373 LA Primary

Addresses

Primary practice location

2103 S Grand St
Monroe, LA 71202-2521

Mailing address

364 GB Cooley Rd
West Monroe, LA 71291-8866
Phone (318) 396-6300

Other identifiers 1

IdentifierTypeStateIssuer
1716235MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
G B Cooley Services Latham29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

2103 S Grand St
Monroe, LA 71202

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629100862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 GB COOLEY RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712918866",
            "telephone_number": "318-396-6300",
            "fax_number": "318-396-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 S GRAND ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712022521",
            "telephone_number": "318-396-6300",
            "fax_number": "318-396-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G B COOLEY SERVICES SOUTH GRAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PITTS",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-396-6300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1716235",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, 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.