Northwest Supports and Services Center

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

750000461 Issued in LA

Legal business name

NORTHWEST SUPPORTS AND SERVICES CENTER

Practice address

5401 Shed Rd
Bossier City, LA 71111-5420

Phone

(318) 741-5230

Fax

(318) 741-5303

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. David Colvin

Title

Administrator

Phone

(318) 741-5200

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Northwest Louisiana Developmental Center Former legal business name

Tax ID family

Northwest Louisiana Developmental Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

• Northwest Supports and Services Center

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bossier City, LA
  • NPI 1467670869
  NPD tax ID
• Northwest Supports and Services Center

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bossier City, LA
  • NPI 1558589952
  NPD tax ID
• Northwest Supports and Services Center

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bossier City, LA
  • NPI 1730307133
  NPD tax ID
• Northwest Supports and Services Center

  • Early Intervention Provider Agency
  • Bossier City, LA
  • NPI 1871732628
  NPD tax ID
• Northwest Supports and Services Center

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bossier City, LA
  • NPI 1912125311
  NPD tax ID

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235692800000",
    "number": "1689715179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 SHED RD",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115420",
            "telephone_number": "318-741-5230",
            "fax_number": "318-741-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 SHED RD",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115420",
            "telephone_number": "318-741-5230",
            "fax_number": "318-741-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SUPPORTS AND SERVICES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2009-02-27",
        "status": "A",
        "authorized_official_last_name": "COLVIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-741-5200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "750000461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1156761",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1712035",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1156752",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1567230",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1408182",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Louisiana Developmental Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• North Louisiana Surgery Center LLC
• Northeast Louisiana Physicians, LLC
• Jennifer Northern, CIT
• Northwest Supports and Services Center
• Northwest Supports and Services Center
• Northwest Supports and Services Center
• Northwest Supports and Services Center
• Northwest Supports and Services Center
• Laurie L. Nussbaum, MSW, LCSW
• NW la War Veterans Home

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; 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.