NPIMap

Organization Active NPI

Wendover Community Home

  • Intellectual Disabilities Intermediate Care Facility
  • Alexandria, LA
National Provider Identifier
1669867545
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
WENDOVER COMMUNITY HOME
Practice address
4607 Wendover Blvd
Alexandria, LA 71303-2528
Phone
(318) 445-1635
Fax
(318) 473-0490
NPI assigned
Mar 30, 2015
Last updated
Apr 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Authorized official

Name
Mr. Earl Humphries
Title
Owner
Phone
(318) 445-1635

Specialties & licenses 1

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

Addresses

Primary practice location

4607 Wendover Blvd
Alexandria, LA 71303-2528

Mailing address

4607 Wendover Blvd
Alexandria, LA 71303-2528
Phone (318) 445-1635

National Provider Directory

National Provider Directory
Tax ID family
Peach Community Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1669867545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4607 WENDOVER BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032528",
            "telephone_number": "318-445-1635",
            "fax_number": "318-473-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 WENDOVER BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032528",
            "telephone_number": "318-445-1635",
            "fax_number": "318-473-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENDOVER COMMUNITY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "HUMPHRIES",
        "authorized_official_first_name": "EARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-445-1635",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.