NPIMap

Organization Active NPI

St Marys Resd Training School

Doing business as Msgr Joseph M Susi Knights of Columbus Home

  • Intellectual Disabilities Intermediate Care Facility
  • Boyce, LA
National Provider Identifier
1669666475
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
996 Issued in LA
Legal business name
ST MARYS RESD TRAINING SCHOOL
Doing business as
Msgr Joseph M Susi Knights of Columbus Home
Practice address
1701 Madeley Avenue
Boyce, LA 71409-9312
Phone
(318) 445-8717
NPI assigned
Sep 5, 2007
Last updated
Sep 5, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
ST MARYS RESD TRAINING SCHOOLAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Authorized official

Name
Mrs. Christi Guillot
Title
Administrative Service Director
Phone
(318) 445-6443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 996 LA Primary

Addresses

Primary practice location

1701 Madeley Avenue
Boyce, LA 71409-9312

Mailing address

PO Drawer 7768
Alexandria, LA 71306
Phone (318) 445-6443

Other identifiers 1

IdentifierTypeStateIssuer
1456691MedicaidLA

Other names 1

  • Msgr Joseph M Susi Knights of Columbus Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669666475. Details of each certification follow.

  • CCN 19G996 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 19G996

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Monsignor Joseph M Susi-Knights Of Columbus
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Sep 22, 2006
Last certification
Jun 3, 2025
Beds
8
Ownership / control type
Private (non-profit)
Facility address
1701 Madeley Avenue
Boyce, LA 71409

National Provider Directory

National Provider Directory
Tax ID family
St Marys Resd Training School27 organizations share this tax ID, including this one
Part of
St Marys Resd Training School

Other organizations with this tax ID 26

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

View all 26

Locations

1701 Madeley Ave
Boyce, LA 71409
Phone (318) 445-8717

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188950400000",
    "number": "1669666475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER 7768",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71306",
            "telephone_number": "318-445-6443",
            "fax_number": "318-449-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 MADELEY AVENUE",
            "city": "BOYCE",
            "state": "LA",
            "postal_code": "714099312",
            "telephone_number": "318-445-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS RESD TRAINING SCHOOL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST MARYS RESD TRAINING SCHOOL",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A",
        "authorized_official_last_name": "GUILLOT",
        "authorized_official_first_name": "CHRISTI",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICE DIRECTOR",
        "authorized_official_telephone_number": "318-445-6443",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "LA",
            "license": "996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1456691",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Msgr Joseph M Susi Knights of Columbus Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boyce, LA

Sources for this page

Verify at the official NPI Registry.