NPIMap

Organization Active NPI

Southwest la Developmental Center

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Iota, LA
National Provider Identifier
1871783415
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
13532 Issued in LA
Legal business name
SOUTHWEST LA DEVELOPMENTAL CENTER
Practice address
224 Gremillion Circle
Iota, LA 70543
Phone
(337) 824-6250
Fax
(337) 821-9306
NPI assigned
Jul 30, 2007
Last updated
Jul 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

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

Authorized official

Name
Mr. Samuel K McDaniel
Title
Mr/DD Regional Administrator
Phone
(337) 824-6250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 13532 LA Primary

Addresses

Primary practice location

224 Gremillion Circle
Iota, LA 70543

Mailing address

224 Gremillion Circle
Iota, LA 70543
Phone (337) 824-6250

Other identifiers 1

IdentifierTypeStateIssuer
1102695OtherLACHILD PLACING FOSTER CARE

National Provider Directory

National Provider Directory
Tax ID family
Acadiana Region Supports Services Center19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1871783415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 GREMILLION CIRCLE",
            "city": "IOTA",
            "state": "LA",
            "postal_code": "70543",
            "telephone_number": "337-824-6250",
            "fax_number": "337-821-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 GREMILLION CIRCLE",
            "city": "IOTA",
            "state": "LA",
            "postal_code": "70543",
            "telephone_number": "337-824-6250",
            "fax_number": "337-821-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST LA DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MR/DD REGIONAL ADMINISTRATOR",
        "authorized_official_telephone_number": "337-824-6250",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "13532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILD PLACING FOSTER CARE",
            "identifier": "1102695",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iota, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.