NPIMap

Organization Active NPI

Desoto Council on Aging

  • Case Management Agency
  • Mansfield, LA
National Provider Identifier
1639205487
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
3580 Issued in LA
Legal business name
DESOTO COUNCIL ON AGING
Practice address
1004 Polk St
Mansfield, LA 71052-2523
Phone
(318) 872-0671
Fax
(318) 872-9473
NPI assigned
Feb 26, 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
Mrs. Martha B Jones
Title
Executive Director
Phone
(318) 872-0671

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 3580 LA Primary

Addresses

Primary practice location

1004 Polk St
Mansfield, LA 71052-2523

Mailing address

PO Box 996
Mansfield, LA 71052-0996
Phone (318) 872-0671

Other identifiers 3

IdentifierTypeStateIssuer
1461229MedicaidLA
1964352MedicaidLA
1393444MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Desoto Council on Aging4 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": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639205487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 996",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "710520996",
            "telephone_number": "318-872-0671",
            "fax_number": "318-872-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 POLK ST",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "710522523",
            "telephone_number": "318-872-0671",
            "fax_number": "318-872-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO COUNCIL ON AGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "318-872-0671",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "LA",
            "license": "3580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1461229",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1964352",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1393444",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, 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.