NPIMap

Organization Active NPI

Leesville Developmental Center

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Leesville, LA
National Provider Identifier
1689893646
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
LEESVILLE DEVELOPMENTAL CENTER
Practice address
200 S 8TH St
Leesville, LA 71446-4208
Phone
(337) 239-2687
NPI assigned
Apr 25, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Tommy Brooks
Title
Facility Services Director
Phone
(337) 239-2687

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X LA Primary

Addresses

Primary practice location

200 S 8TH St
Leesville, LA 71446-4208

Mailing address

PO Box 131
Leesville, LA 71496-0131
Phone (337) 239-2687

Other identifiers 1

IdentifierTypeStateIssuer
1712043MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Shamrock Street Pharmacy11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689893646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 131",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714960131",
            "telephone_number": "337-239-2687",
            "fax_number": "337-238-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S 8TH ST",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464208",
            "telephone_number": "337-239-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEESVILLE DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_title_or_position": "FACILITY SERVICES DIRECTOR",
        "authorized_official_telephone_number": "337-239-2687",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1712043",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.