NPIMap

Organization Active NPI

Pinecrest Developmental Center

  • Community/Behavioral Health Agency
  • Pineville, LA
National Provider Identifier
1740406339
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
6653 Issued in LA
Legal business name
PINECREST DEVELOPMENTAL CENTER
Practice address
100 Pinecrest Drive
Pineville, LA 71351
Phone
(318) 641-2000
Fax
(318) 641-2309
NPI assigned
Apr 18, 2007
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
Mrs. Sherri A Evans
Title
Mr DD Regional Administrator
Phone
(318) 641-2003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6653 LA Primary

Addresses

Primary practice location

100 Pinecrest Drive
Pineville, LA 71351

Mailing address

PO Box 5191
Pineville, LA 71361-5191
Phone (318) 641-2000

Other identifiers 1

IdentifierTypeStateIssuer
1564419MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Pinecrest Supports and Services Center19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740406339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5191",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713615191",
            "telephone_number": "318-641-2000",
            "fax_number": "318-641-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PINECREST DRIVE",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "71351",
            "telephone_number": "318-641-2000",
            "fax_number": "318-641-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MR DD REGIONAL ADMINISTRATOR",
        "authorized_official_telephone_number": "318-641-2003",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "6653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1564419",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, 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.