Active NPI
Melbrook Community Home
- Intellectual Disabilities Intermediate Care Facility
- Gretna, LA
National Provider Identifier
1821241712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- Legal business name
- MELBROOK COMMUNITY HOME
- Practice address
- 336 Melbrook Dr
Gretna, LA 70056-7715 - Phone
- (504) 366-1828
- Fax
- (504) 366-1867
- NPI assigned
- Oct 23, 2008
- Organization subpart
- Yes
- Parent organization
- CROSSROADS LOUISIANA, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Susan McIlwain
- Title
- Executive Director
- Phone
- (504) 366-1828
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Primary |
Addresses
Primary practice location
336 Melbrook Dr
Gretna, LA 70056-7715
Mailing address
PO Box 6987
New Orleans, LA 70174-6987
Phone (504) 366-1828
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1718289 | Medicaid | LA | |
| 1719684 | Medicaid | LA | |
| 1910074 | Medicaid | LA | |
| 1918571 | Medicaid | LA | |
| 1454257 | Medicaid | LA | |
| 1718378 | Medicaid | LA | |
| 1719595 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Intermediate care facility for individuals with intellectual disabilities certification: CCN 19G601
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- Melbrook Community Home
- Certification status
- Active
- Provider type (POS)
- Intermediate care facility for individuals with intellectual disabilities
- Participating since
- Apr 24, 2009
- Last certification
- Mar 26, 2025
- Beds
- 6
- Ownership / control type
- Private (non-profit)
- Facility address
- 336 Melbrook Drive
Gretna, LA 70056
National Provider Directory
National Provider Directory- Tax ID family
- Crossroads Louisiana in
- Part of
- Crossroads Louisiana in
Other organizations with this tax ID 7
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- New Orleans, LA
- NPI 1366573115
-
- Assisted Living Facility
- New Orleans, LA
- NPI 1417088816
-
- Intellectual Disabilities Intermediate Care Facility
- New Orleans, LA
- NPI 1124148507
-
- Intellectual Disabilities Intermediate Care Facility
- New Orleans, LA
- NPI 1245350602
-
- Intellectual Disabilities Intermediate Care Facility
- New Orleans, LA
- NPI 1508986977
-
- Intellectual Disabilities Intermediate Care Facility
- Gretna, LA
- NPI 1679693014
-
- Intellectual Disabilities Intermediate Care Facility
- New Orleans, LA
- NPI 1760504625
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224720000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1224720000000",
"number": "1821241712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6987",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701746987",
"telephone_number": "504-366-1828",
"fax_number": "504-366-1867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "336 MELBROOK DR",
"city": "GRETNA",
"state": "LA",
"postal_code": "700567715",
"telephone_number": "504-366-1828",
"fax_number": "504-366-1867"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MELBROOK COMMUNITY HOME",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CROSSROADS LOUISIANA, INC.",
"enumeration_date": "2008-10-23",
"last_updated": "2008-10-23",
"status": "A",
"authorized_official_last_name": "MCILWAIN",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "504-366-1828",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1718289",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1719684",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1910074",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1918571",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1454257",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1718378",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1719595",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gretna, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.