Colwell Interest, Inc.
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Mansfield, LA
NPI 1801124284 · NPPES record last updated Nov 24, 2009
Key facts
- NPI
- 1801124284
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- License
- 1062 (LA)
- Legal business name
- COLWELL INTEREST, INC.
- Practice address
- 167 Poole Rd
Mansfield, LA 71052-5007 - Phone
- (318) 442-2284
- Fax
- (318) 448-1427
- NPI assigned
- Nov 24, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- COLWELL INTEREST, INC.
Authorized official
- Name
- Mr. James B. Colwell
- Title
- Program Manager
- Phone
- (318) 442-2284
Corporate family (same tax ID) 9
National Provider Directory
- Tax ID family
- Pineville Adult Day Care
- Part of
- Pineville Adult Day Care
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | 1062 | LA | Yes |
Addresses
Primary practice location
167 Poole Rd
Mansfield, LA 71052-5007
Mailing address
1111 Main St
Pineville, LA 71360-6423
Phone (318) 442-2284
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1718971 | Medicaid | LA |
Other names
- Pecan Grove Community Home
Other providers in Mansfield, LA
- Karla Chamberlin
- Christopher Shelby M D a Professional Medical Corporation
- Cognitive Institute Incorporated
- Daphne Coleman
- Colwell Interest, Inc.
- Caitlyn Corley
- Council for Advancement of Social Service and Education
- Council for the Advancement of Social Services and Education
- Council for the Advancement of Social Servies and Education
- Ashley Coutee
All providers in Mansfield, LA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.