NPIMap

Organization Active NPI

North Lake Supports & Services Center

Doing business as Julia St. Community Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Albany, LA
National Provider Identifier
1801070065
Registry record updated Dec 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
APPLIED FOR Issued in LA
Legal business name
NORTH LAKE SUPPORTS & SERVICES CENTER
Doing business as
Julia St. Community Home
Practice address
30199 Julia Street
Albany, LA 70711
Phone
(225) 567-3111
Fax
(225) 567-2017
NPI assigned
Dec 24, 2007
Last updated
Dec 24, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
LA DEPT OF HEALTH & HOSPITALSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 24, 2007

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

Authorized official

Name
Mr. Kindred Hodge
Title
Administrator
Phone
(225) 567-3111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X APPLIED FOR LA Primary

Addresses

Primary practice location

30199 Julia Street
Albany, LA 70711

Mailing address

45439 Live Oak Dr
Hammond, LA 70401-4526
Phone (225) 567-3111

Other names 1

  • Julia St. Community Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rene Drive Community Home12 organizations share this tax ID, including this one
Part of
Shamrock Street Pharmacy

Other organizations with this tax ID 11

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": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198454400000",
    "number": "1801070065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45439 LIVE OAK DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704014526",
            "telephone_number": "225-567-3111",
            "fax_number": "225-567-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30199 JULIA STREET",
            "city": "ALBANY",
            "state": "LA",
            "postal_code": "70711",
            "telephone_number": "225-567-3111",
            "fax_number": "225-567-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH LAKE SUPPORTS & SERVICES CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA DEPT OF HEALTH & HOSPITALS",
        "enumeration_date": "2007-12-24",
        "last_updated": "2007-12-24",
        "status": "A",
        "authorized_official_last_name": "HODGE",
        "authorized_official_first_name": "KINDRED",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "225-567-3111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "APPLIED FOR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Julia St. Community Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2007; 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.