NPIMap

Organization Active NPI

Southern Comfort Community Homes, LLC

Doing business as Ledia Simon Group Home

  • Nursing Facility/Intermediate Care Facility
  • Rayne, LA
National Provider Identifier
1851410385
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
918 Issued in LA
Legal business name
SOUTHERN COMFORT COMMUNITY HOMES, LLC
Doing business as
Ledia Simon Group Home
Practice address
3779 Heritage Rd
Rayne, LA 70578-7750
Phone
(337) 363-2969
Fax
(337) 363-5974
NPI assigned
Mar 28, 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
Carolyn Deranger
Title
Office Manager
Phone
(337) 363-2969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 918 LA Primary

Addresses

Primary practice location

3779 Heritage Rd
Rayne, LA 70578-7750

Mailing address

PO Box 810
Ville Platte, LA 70586-0810
Phone (337) 363-2969

Other identifiers 1

IdentifierTypeStateIssuer
1710784MedicaidLA

Other names 1

  • Ledia Simon Group Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Comfort Community Homes LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

3779 Heritage Rd
Rayne, LA 70578
Phone (337) 363-2969

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851410385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705860810",
            "telephone_number": "337-363-2969",
            "fax_number": "337-363-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3779 HERITAGE RD",
            "city": "RAYNE",
            "state": "LA",
            "postal_code": "705787750",
            "telephone_number": "337-363-2969",
            "fax_number": "337-363-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COMFORT COMMUNITY HOMES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DERANGER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "337-363-2969"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "LA",
            "license": "918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710784",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ledia Simon Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rayne, 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.