Provisions Care and Residential Services, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

PROVISIONS CARE AND RESIDENTIAL SERVICES, LLC

Practice address

7125 Villere Dr
Baker, LA 70714-5347

Phone

(225) 775-8188

Fax

(225) 775-8189

NPI assigned

Aug 22, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Charlette Marie Minor

Title

Owner/Administrator

Phone

(225) 775-8188

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377129600000",
    "number": "1699109983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 VILLERE DR",
            "city": "BAKER",
            "state": "LA",
            "postal_code": "707145347",
            "telephone_number": "225-775-8188",
            "fax_number": "225-775-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 VILLERE DR",
            "city": "BAKER",
            "state": "LA",
            "postal_code": "707145347",
            "telephone_number": "225-775-8188",
            "fax_number": "225-775-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISIONS CARE AND RESIDENTIAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-22",
        "status": "A",
        "authorized_official_last_name": "MINOR",
        "authorized_official_first_name": "CHARLETTE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "225-775-8188",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.