NPIMap

Organization Active NPI

Louise S Davis Residential Facilities, LLC

Doing business as Dundee Community Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Bossier City, LA
National Provider Identifier
1790801264
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
License
969 Issued in LA
Legal business name
LOUISE S DAVIS RESIDENTIAL FACILITIES, LLC
Doing business as
Dundee Community Home
Practice address
2901 Douglas Dr
Bossier City, LA 71111-5807
Phone
(337) 439-6600
Fax
(337) 439-6647
NPI assigned
Mar 22, 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
Kendall A Broussard
Title
Managing Member
Phone
(337) 439-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 969 LA Primary

Addresses

Primary practice location

2901 Douglas Dr
Bossier City, LA 71111-5807

Mailing address

1 Lakeshore Dr
Suite 1900
Lake Charles, LA 70629-0100
Phone (337) 439-6600

Other identifiers 1

IdentifierTypeStateIssuer
1718726MedicaidLA

Other names 1

  • DUNDEE COMMUNITY HOME Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Louise S Davis Residential Facilities LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

1 Lakeshore Dr
Ste 1900
Lake Charles, LA 70629

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790801264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LAKESHORE DR",
            "address_2": "SUITE 1900",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706290100",
            "telephone_number": "337-439-6600",
            "fax_number": "337-439-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 DOUGLAS DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115807",
            "telephone_number": "337-439-6600",
            "fax_number": "337-439-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISE S DAVIS RESIDENTIAL FACILITIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROUSSARD",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "337-439-6600"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1718726",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DUNDEE COMMUNITY HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bossier City, 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.