NPIMap

Organization Active NPI

Mary Marcombe Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Donaldsonville, LA
National Provider Identifier
1649496142
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
495 Issued in LA
Legal business name
MARY MARCOMBE HOME
Practice address
1030 Clay St
Donaldsonville, LA 70346-3518
Phone
(225) 473-4516
Fax
(225) 473-4517
NPI assigned
Apr 17, 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. Marlene Benoit Domingue, RN
Title
Executive Director
Phone
(225) 473-4516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 495 LA Primary

Addresses

Primary practice location

1030 Clay St
Donaldsonville, LA 70346-3518

Mailing address

1030 Clay St
PO Box 624
Donaldsonville, LA 70346-3518
Phone (225) 473-4516

Other identifiers 1

IdentifierTypeStateIssuer
1717339MedicaidLA

Other names 1

  • DONALDSONVILLE AARC INC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Donaldsonville Aarc Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

1030 Clay St
Donaldsonville, LA 70346
Phone (225) 473-4516

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649496142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 CLAY ST",
            "address_2": "PO BOX 624",
            "city": "DONALDSONVILLE",
            "state": "LA",
            "postal_code": "703463518",
            "telephone_number": "225-473-4516",
            "fax_number": "225-473-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 CLAY ST",
            "city": "DONALDSONVILLE",
            "state": "LA",
            "postal_code": "703463518",
            "telephone_number": "225-473-4516",
            "fax_number": "225-473-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY MARCOMBE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOMINGUE",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "BENOIT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "225-473-4516",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1717339",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DONALDSONVILLE AARC INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Donaldsonville, 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.