NPIMap

Organization Active NPI

Arkansas Elder Outreach of Little Rock, Inc

Doing business as Southwind Nursing & Rehab Center

  • Skilled Nursing Facility
  • Crowley, LA
National Provider Identifier
1669559910
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
845 Issued in LA
Legal business name
ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC
Doing business as
Southwind Nursing & Rehab Center
Practice address
804 Crowley Rayne Hwy
Crowley, LA 70526-8208
Phone
(337) 783-2740
Fax
(337) 783-3058
NPI assigned
Nov 1, 2006
Last updated
May 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Authorized official

Name
Bonnie Quibodeaux
Title
Cfo
Phone
(225) 769-7960

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 845 LA Primary

Addresses

Primary practice location

804 Crowley Rayne Hwy
Crowley, LA 70526-8208

Mailing address

804 Crowley Rayne Hwy
Crowley, LA 70526-8208
Phone (337) 783-2740

Other identifiers 1

IdentifierTypeStateIssuer
1515523MedicaidLA

Other names 1

  • Southwind Nursing & Rehab Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100113000091 LA Part A Provider - Skilled Nursing Facility 4880505858 Practice locations: Crowley, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669559910. Details of each certification follow.

Skilled nursing facility certification: CCN 195563

Legal name
ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC.
Doing business as
SOUTHWIND HEALTHCARE & REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Aug 2, 2002
Last certification
Oct 16, 2024
Beds
112
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Elder Outreach
Organization structure
CorporationNon-profit
Incorporated
Dec 26, 2002 in AR
Enrollment address
804 Crowley Rayne Hwy
Crowley, LA 70526-8208
Nursing home name
SOUTHWIND NURSING & REHABILITATION CENTER
Affiliated entity
ELDER OUTREACH NURSING & REHABILITATION

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Southwind Nursing & Rehabilitation CenterCCN 195563 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Aug 2, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
112101.4 residents per day on average
Chain
Elder Outreach Nursing & Rehabilitation5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Elder Outreach of Little Rock Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

804 Crowley Rayne Hwy
Crowley, LA 70526
Phone (337) 783-2740

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jerad Langley Individual W-2 Managing EmployeeAdministrator Aug 3, 2015
Todd Cole Individual Corporate Director Sep 16, 2015
Jude Sittig Individual Corporate DirectorBoard Member Feb 17, 2010
Bonnie Quibodeaux Individual Corporate Officer Feb 1, 2018
Other Feb 1, 2018
Kati Presas Individual Corporate DirectorDirector Dec 15, 2021
Douglas M Walsh Individual Corporate Director Dec 26, 2002
Cory Gatte Individual Corporate Director Nov 29, 2017

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1669559910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 CROWLEY RAYNE HWY",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705268208",
            "telephone_number": "337-783-2740",
            "fax_number": "337-783-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 CROWLEY RAYNE HWY",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705268208",
            "telephone_number": "337-783-2740",
            "fax_number": "337-783-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "QUIBODEAUX",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "225-769-7960"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515523",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwind Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southwind Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crowley, LA

Sources for this page

Verify at the official NPI Registry.