Arkansas Elder Outreach of Little Rock, Inc.
Organization Active NPI Skilled Nursing Facility · Maurice, LA
NPI 1881771012 · NPPES record last updated May 7, 2021
Key facts
- NPI
- 1881771012
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 1011 (LA)
- Legal business name
- ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC.
- Practice address
- 405 Milton Rd
Maurice, LA 70555-4458 - Phone
- (337) 893-4449
- Fax
- (337) 893-8617
- NPI assigned
- Nov 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Bonnie Quibodeaux
- Title
- Cfo
- Phone
- (225) 769-7960
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 4
Practitioners 1
-
Ronald Myron Lahasky, M.D.
Affiliated clinicians 1
-
Ronald Myron Lahasky, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Pelican Pointe Healthcare and Rehabilitation
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Jun 1, 1995
- Medicare certification status
- Active
- Certified beds
- 120 · 115.1 residents per day on average
- Chain
- Elder Outreach Nursing & Rehabilitation
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Skilled nursing facility certification: CCN 195342
- Legal name
- ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC.
- Doing business as
- PELICAN POINTE HEALTHCARE & REHABILITATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Jun 1, 1995
- Last certification
- Oct 9, 2024
- Beds
- 120
- Ownership / control type
- Other Nonprofit
- Multi-facility organization
- Elder Outreach
- Organization structure
- Corporation · Non-profit
- Incorporated
- Dec 26, 2002 in AR
- Enrollment address
- 405 Milton Rd
Maurice, LA 70555-4458 - Nursing home name
- PELICAN POINTE HEALTHCARE AND REHABILITATION
- Affiliated entity
- ELDER OUTREACH NURSING & REHABILITATION
All disclosed owners & managing parties 6
| Name | Role | Since | Share |
|---|---|---|---|
| Todd Cole |
Corporate Director | Sep 16, 2015 | |
| W-2 Managing Employee | Oct 1, 2011 | ||
| Other | Oct 1, 2011 | ||
| Jude Sittig |
Corporate Director |
Feb 17, 2010 | |
| Bonnie Quibodeaux |
Other | Feb 1, 2018 | |
| Kati Presas |
Corporate Director |
Dec 15, 2021 | |
| Douglas M Walsh |
Corporate Director | Jan 1, 2010 | |
| Cory Gatte |
Corporate Director | Nov 29, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100113000237 | LA | Part a Provider - Skilled Nursing Facility | 4880505858 | Practice locations: Maurice, LA |
National Provider Directory
- Tax ID family
- Arkansas Elder Outreach of Little Rock Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1011 | LA | Yes |
Addresses
Primary practice location
405 Milton Rd
Maurice, LA 70555-4458
Mailing address
405 Milton Rd
Maurice, LA 70555-4458
Phone (337) 893-4449
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1510815 | Medicaid | LA |
Other names
- Pelican Pointe Healthcare and Rehabilitaiton
Other providers in Maurice, LA
- Abbeville General Hospital
- Abshire Chiropractic, LLC
- Rowdy Cain Abshire
- Aligned Lanes Medical Transportation LLC
- Cher Yan Aymond
- Emily Barousse Alleman
- Gabrielle Mire Black
- Amanda Percle Broussard
- Kali A Broussard
All providers in Maurice, LA · Skilled Nursing 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 May 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.