NPIMap

Organization Active NPI

Zachary Manor Nursing & Rehabilitation Center LLC

Doing business as Zachary Manor Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • Zachary, LA
National Provider Identifier
1700823184
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
886 Issued in LA
Legal business name
ZACHARY MANOR NURSING & REHABILITATION CENTER LLC
Doing business as
Zachary Manor Nursing & Rehabilitation Center
Practice address
6161 Main St
Zachary, LA 70791-4034
Phone
(225) 654-6893
Fax
(225) 654-6369
NPI assigned
Jun 2, 2006
Last updated
Sep 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Authorized official

Name
Teddy Ray Price
Title
Managing Member
Phone
(318) 628-4116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 886 LA Primary

Addresses

Primary practice location

6161 Main St
Zachary, LA 70791-4034

Mailing address

6161 Main St
Zachary, LA 70791-4034
Phone (225) 654-6893

Other identifiers 1

IdentifierTypeStateIssuer
1510947MedicaidLA

Other names 1

  • ZACHARY MANOR NURSING & REHABILITATION CENTER Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050217000963 LA Part A Provider - Skilled Nursing Facility 5092767095 Practice locations: Zachary, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700823184. Details of each certification follow.

Skilled nursing facility certification: CCN 195362

Legal name
ZACHARY MANOR NURSING & REHABILITATION CENTER LLC
Doing business as
ZACHARY MANOR NURSING & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 1, 1996
Last certification
Jan 8, 2025
Beds
110
Ownership / control type
Corporation
Multi-facility organization
Kisatchie Corporation/ Central Management Company
Organization structure
LLCProprietary
Enrollment address
6161 Main St
Zachary, LA 70791-4034
Nursing home name
ZACHARY MANOR NURSING AND REHABILITATION CENTER
Affiliated entity
CENTRAL MANAGEMENT COMPANY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Zachary Manor Nursing and Rehabilitation CenterCCN 195362 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11070.7 residents per day on average
Chain
Central Management Company21 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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
19D0670979Zachary Manor Nursing & Rehabilitation Center6161 Main Street, Zachary, LA 70791Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Individual Adp of the SNF Jan 1, 2005
Teddy D Price Individual Operational/Managerial Control Mar 1, 2025
Adp of the SNF Mar 1, 2025
Individual Adp of the SNF Jan 1, 2010
Jeffrey Lee Cantrell Individual Adp of the SNF Oct 1, 2013
Holly Maumalanga Individual 5% Or Greater Indirect Ownership Interest Mar 31, 2025 5.52%
Adp of the SNF Mar 31, 2025
Prico, Inc Organization, Winnfield, LA Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2005 48%
Adp of the SNF Jan 1, 2005
Teddy R Price Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2005 76.27%
Operational/Managerial Control Jan 1, 2005
Adp of the SNF Jan 1, 2005
Central Management Company, LLC Organization, Winnfield, LA LLC, Management services company, Chain home office Operational/Managerial Control Jan 1, 2005 100%
Adp of the SNF May 23, 2025
Organization, Winnfield, LA LLC, Consulting firm Adp of the SNF May 23, 2025
Organization, Winnfield, LA LLC, Holding company Adp of the SNF Feb 1, 2001
Dawn Rogers Individual Adp of the SNF Jan 1, 2005
Organization, Lake Charles, LA LLC Adp of the SNF Apr 8, 2025
Individual Adp of the SNF Jan 1, 2011
Kistachie Health, LLC Organization, Winnfield, LA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 2008 52%
Adp of the SNF Jan 1, 2005
Sheila M Bolwahnn Individual Adp of the SNF Dec 1, 2008
James Shelton Individual Adp of the SNF Jan 1, 2005
Individual Adp of the SNF Mar 18, 2025
Individual Adp of the SNF Jan 1, 2005
Organization, Lake Charles, LA LLC, Consulting firm Adp of the SNF Apr 8, 2025
Individual Adp of the SNF Mar 18, 2025
Individual Adp of the SNF Apr 8, 2025
Individual Adp of the SNF Apr 8, 2025
Freda P Zimmerman Individual 5% Or Greater Indirect Ownership Interest Mar 31, 2025 12.14%
Adp of the SNF Mar 31, 2025

Facilities with the same owner 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1700823184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 MAIN ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914034",
            "telephone_number": "225-654-6893",
            "fax_number": "225-654-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 MAIN ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914034",
            "telephone_number": "225-654-6893",
            "fax_number": "225-654-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZACHARY MANOR NURSING & REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "TEDDY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "318-628-4116"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510947",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ZACHARY MANOR NURSING & REHABILITATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Zachary, LA

Sources for this page

Verify at the official NPI Registry.