NPIMap

Organization Active NPI

Ferriday Behavioral Health System LLC

  • Psychiatric Hospital
  • Ferriday, LA
National Provider Identifier
1679147284
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
FERRIDAY BEHAVIORAL HEALTH SYSTEM LLC
Practice address
1700 Ee Wallace Blvd N
Ferriday, LA 71334-2239
Phone
(318) 740-2400
Fax
(318) 460-7172
NPI assigned
May 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Timothy Jason Reed
Title
Manager
Phone
(337) 802-1336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

1700 Ee Wallace Blvd N
Ferriday, LA 71334-2239

Mailing address

187 S Tonti Dr
Many, LA 71449-5848

Other names 1

  • Freedom Behavioral Hospital of Ferriday Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210701000647 LA Part A Provider - Hospital 8820499551 Practice locations: Ferriday, LA

Hospital certification: CCN 194119

Legal name
FERRIDAY BEHAVIORAL HEALTH SYSTEM LLC
Doing business as
FREEDOM BEHAVIORAL HOSPITAL OF FERRIDAY
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Dec 20, 2022
Last certification
Dec 20, 2022
Beds
64
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
May 14, 2021 in LA
Enrollment address
1700 Ee Wallace Blvd N
Ferriday, LA 71334-2239
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Freedom Behavioral Hospital of FerridayCCN 194119
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2233699Ferriday Behavioral Health System1700 Ee Wallace Blvd N, Ferriday, LA 71334Certificate of waiverAug 24, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Rock Bordelon Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 40%
TCD Holdings LLC Organization, Monroe, LA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 10%
Tara Cylyce Reed Individual Contracted Managing Employee Apr 1, 2024
Thomas C Dansby Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 10%
Kelly Coburn Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 5%
Steven Orlando Richard Individual W-2 Managing EmployeeAd; Jan 31, 2023
Freedom Behavioral Hospital of Ferriday LLC Organization, Many, LA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2024 100%
PKC Investments, LLC Organization, Monroe, LA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 10%
Althea T Conley Individual Contracted Managing EmployeeMD; May 23, 2020
Paul B Coburn Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 5%
Timothy Jason Reed Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 40%
Corporate Officer Apr 1, 2024
Operational/Managerial Control Apr 10, 2024
Rocknjay Investments LLC Organization, Many, LA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2024 80%
Azizah Verrett Individual Contracted Managing Employee Apr 1, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1679147284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 S TONTI DR",
            "city": "MANY",
            "state": "LA",
            "postal_code": "714495848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 EE WALLACE BLVD N",
            "city": "FERRIDAY",
            "state": "LA",
            "postal_code": "713342239",
            "telephone_number": "318-740-2400",
            "fax_number": "318-460-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERRIDAY BEHAVIORAL HEALTH SYSTEM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "337-802-1336"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freedom Behavioral Hospital of Ferriday",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ferriday, LA

Sources for this page

Verify at the official NPI Registry.