NPIMap

Organization Active NPI

Pinecrest Developmental Center

Doing business as Central LA Resource Center

  • Community/Behavioral Health Agency
  • Alexandria, LA
National Provider Identifier
1881974749
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PINECREST DEVELOPMENTAL CENTER
Doing business as
Central LA Resource Center
Practice address
2006 Gus Kaplan Dr
Alexandria, LA 71301-3376
Phone
(318) 487-5395
Fax
(318) 487-5463
NPI assigned
Aug 24, 2011
Last updated
Aug 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Authorized official

Name
Mr. Paxton Enis Oliver II, M.S.NPI 1952634222
Title
Mr/DD Regional Associate Administer
Phone
(318) 487-5395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X LA
Community/Behavioral Health Agency 251S00000X LA Primary

Addresses

Primary practice location

2006 Gus Kaplan Dr
Alexandria, LA 71301-3376

Mailing address

2006 Gus Kaplan Dr
Alexandria, LA 71301-3376
Phone (318) 487-5395

Other names 1

  • Central LA Resource Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pinecrest Developmental 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

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.

NPI Registry JSON

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1881974749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 GUS KAPLAN DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013376",
            "telephone_number": "318-487-5395",
            "fax_number": "318-487-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 GUS KAPLAN DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013376",
            "telephone_number": "318-487-5395",
            "fax_number": "318-487-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "PAXTON",
        "authorized_official_middle_name": "ENIS",
        "authorized_official_title_or_position": "MR/DD REGIONAL ASSOCIATE ADMINISTER",
        "authorized_official_telephone_number": "318-487-5395",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central LA Resource Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.