NPIMap

Organization Active NPI

Northeast la Home Care

  • Custodial Care Facility
  • Columbia, LA
National Provider Identifier
1669533261
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
10414 Issued in LA
Legal business name
NORTHEAST LA HOME CARE
Practice address
8636 Hwy 165 S
Columbia, LA 71418
Phone
(318) 649-0653
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Mrs. Glenda Faye Smith
Title
President
Phone
(318) 649-0653

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X 10414 LA Primary

Addresses

Primary practice location

8636 Hwy 165 S
Columbia, LA 71418

Mailing address

PO Box 96
Clarks, LA 71415-0096
Phone (318) 649-0653

Other identifiers 1

IdentifierTypeStateIssuer
1469700MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1669533261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96",
            "city": "CLARKS",
            "state": "LA",
            "postal_code": "714150096",
            "telephone_number": "318-649-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8636 HWY 165 S",
            "city": "COLUMBIA",
            "state": "LA",
            "postal_code": "71418",
            "telephone_number": "318-649-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST LA HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-649-0653",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "LA",
            "license": "10414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1469700",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 23, 2008; 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.