NPIMap

Organization Active NPI

Columbia Developmental Center

Doing business as Grayson Community Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Columbia, LA
National Provider Identifier
1659590008
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
941 Issued in LA
Legal business name
COLUMBIA DEVELOPMENTAL CENTER
Doing business as
Grayson Community Home
Practice address
1292 Highway 850
Columbia, LA 71418-1559
Phone
(318) 649-6097
Fax
(318) 649-2868
NPI assigned
Apr 24, 2007
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
Mr. Michael Anthony Harrell
Title
Regional Associate Administrator
Phone
(318) 649-6097

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 941 LA Primary

Addresses

Primary practice location

1292 Highway 850
Columbia, LA 71418-1559

Mailing address

132 Highway 850
Columbia, LA 71418-1559
Phone (318) 649-6097

Other identifiers 1

IdentifierTypeStateIssuer
1725081MedicaidLA

Other names 1

  • Grayson Community Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Columbia Developmental Center10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659590008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 HIGHWAY 850",
            "city": "COLUMBIA",
            "state": "LA",
            "postal_code": "714181559",
            "telephone_number": "318-649-6097",
            "fax_number": "318-649-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1292 HIGHWAY 850",
            "city": "COLUMBIA",
            "state": "LA",
            "postal_code": "714181559",
            "telephone_number": "318-649-6097",
            "fax_number": "318-649-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "REGIONAL ASSOCIATE ADMINISTRATOR",
        "authorized_official_telephone_number": "318-649-6097",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1725081",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grayson Community Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, 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.