NPIMap

Organization Active NPI

Haven's Gateway Personal Care Facility, Inc

  • Home Health Agency
  • Baton Rouge, LA
National Provider Identifier
1790807170
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
SIL 6698 Issued in LA
Legal business name
HAVEN'S GATEWAY PERSONAL CARE FACILITY, INC
Practice address
1200 S Acadian Thruway Ste 211
Baton Rouge, LA 70806-6900
Phone
(225) 266-2092
Fax
(225) 343-4742
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Mrs. Alfreda Jackson, B.A.
Title
President/C.E.O.
Phone
(225) 343-4741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X SIL 6698 LA Primary

Addresses

Primary practice location

1200 S Acadian Thruway Ste 211
Baton Rouge, LA 70806-6900

Mailing address

1200 S Acadian Thruway Ste 212
Baton Rouge, LA 70806-6900
Phone (225) 226-2092

Other identifiers 1

IdentifierTypeStateIssuer
1581348MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Haven's Gateway Personal Care Facility Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1790807170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S ACADIAN THRUWAY STE 212",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708066900",
            "telephone_number": "225-226-2092",
            "fax_number": "225-343-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S ACADIAN THRUWAY STE 211",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708066900",
            "telephone_number": "225-266-2092",
            "fax_number": "225-343-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN'S GATEWAY PERSONAL CARE FACILITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ALFREDA",
        "authorized_official_title_or_position": "PRESIDENT/C.E.O.",
        "authorized_official_telephone_number": "225-343-4741",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B.A."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "LA",
            "license": "SIL 6698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1581348",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.