NPIMap

Organization Active NPI

Arkansas Elder Outreach of Little Rock, Inc.

Doing business as Pelican Pointe Healthcare and Rehabilitaiton

  • Skilled Nursing Facility
  • Maurice, LA
National Provider Identifier
1881771012
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1011 Issued in LA
Legal business name
ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC.
Doing business as
Pelican Pointe Healthcare and Rehabilitaiton
Practice address
405 Milton Rd
Maurice, LA 70555-4458
Phone
(337) 893-4449
Fax
(337) 893-8617
NPI assigned
Nov 1, 2006
Last updated
May 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Authorized official

Name
Bonnie Quibodeaux
Title
Cfo
Phone
(225) 769-7960

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1011 LA Primary

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 names 1

  • Pelican Pointe Healthcare and Rehabilitaiton Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100113000237 LA Part A Provider - Skilled Nursing Facility 4880505858 Practice locations: Maurice, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881771012. Details of each certification follow.

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
CorporationNon-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

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pelican Pointe Healthcare and RehabilitationCCN 195342 · All quality measures
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
ActiveFrom the Provider of Services file
Certified beds
120115.1 residents per day on average
Chain
Elder Outreach Nursing & Rehabilitation5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Elder Outreach of Little Rock Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Todd Cole Individual Corporate Director Sep 16, 2015
W-2 Managing Employee Oct 1, 2011
Other Oct 1, 2011
Jude Sittig Individual Corporate DirectorBoard Member Feb 17, 2010
Bonnie Quibodeaux Individual Other Feb 1, 2018
Kati Presas Individual Corporate DirectorDirector Dec 15, 2021
Douglas M Walsh Individual Corporate Director Jan 1, 2010
Cory Gatte Individual Corporate Director Nov 29, 2017

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1881771012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MILTON RD",
            "city": "MAURICE",
            "state": "LA",
            "postal_code": "705554458",
            "telephone_number": "337-893-4449",
            "fax_number": "337-893-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MILTON RD",
            "city": "MAURICE",
            "state": "LA",
            "postal_code": "705554458",
            "telephone_number": "337-893-4449",
            "fax_number": "337-893-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "QUIBODEAUX",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "225-769-7960"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "1011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pelican Pointe Healthcare and Rehabilitaiton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pelican Pointe Healthcare and Rehabilitaiton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maurice, LA

Sources for this page

Verify at the official NPI Registry.