Active NPI
Leslie Lakes Care Center, LLC
- Skilled Nursing Facility
- Arcadia, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 859
- Legal business name
- LESLIE LAKES CARE CENTER, LLC
- Practice address
- 1355 6TH St
Arcadia, LA 71001-3109 - Phone
- (318) 263-9581
- NPI assigned
- Aug 5, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dawne R Smith
- Title
- Ceo
- Phone
- (318) 812-2140
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 859 | LA | Primary |
| Nursing Facility Supplies (DME) | 332BN1400X | |||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X |
Addresses
Primary practice location
1355 6TH St
Arcadia, LA 71001-3109
Mailing address
1355 6TH St
Arcadia, LA 71001-3109
Phone (318) 263-9581
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1510653 | Medicaid | LA |
Other names 1
- Leslie Lakes Retirement Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040129000042 | LA | Part A Provider - Skilled Nursing Facility | 9830092758 | Practice locations: Arcadia, LA |
Skilled nursing facility certification: CCN 195572
- Legal name
- LESLIE LAKES CARE CENTER, LLC
- Doing business as
- LESLIE LAKES RETIREMENT CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Feb 14, 2003
- Last certification
- Dec 11, 2024
- Beds
- 150
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Paramount Healthcare
- Organization structure
- Partnership
- Enrollment address
- 1355 6TH St
Arcadia, LA 71001-3109 - Nursing home name
- LESLIE LAKES RETIREMENT CENTER
- Affiliated entity
- PARAMOUNT HEALTHCARE CONSULTANTS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Leslie Lakes Retirement Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Feb 14, 2003
- Medicare certification status
- Active
- Certified beds
- 150
- Chain
- Paramount Healthcare Consultants
- Penalties (3 years)
- 2
National Provider Directory
National Provider DirectoryLocations
1355 6th St
Arcadia, LA 71001
Phone (318) 263-9581
1905 N 7th St
West Monroe, LA 71291
Phone (318) 812-2140
Ownership & related parties
All disclosed owners & managing parties 11
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| DCZ Healthcare Investments, LLC | Direct Ownership Interest | Jan 1, 2008 | 24% |
| Leslie Lakes Property, LLC | 5% Or Greater Mortgage Interest | Jan 1, 2008 | 100% |
| Adp of the SNF | Jan 1, 2008 | ||
| Stephen Duck, Cpa PC | Adp of the SNF | Jan 1, 2018 | |
| Paramount Healthcare Consultants, LLC | Adp of the SNF | Jan 1, 2008 | |
| DCZ1 Ventures LLC | Adp of the SNF | Jan 1, 2008 | |
| David Colvin | Operational/Managerial Control | May 9, 2017 | |
| Adp of the SNF | May 9, 2017 | ||
| Kelly Coburn | Adp of the SNF | Jan 1, 2008 | |
| Indirect Ownership Interest | Jan 1, 2008 | 50% | |
| PKC Investments, LLC | Adp of the SNF | Jan 1, 2008 | |
| Direct Ownership Interest | Jan 1, 2008 | 73% | |
| Dawne R Smith | Corporate Officer | Jan 1, 2008 | |
| Adp of the SNF | Jan 1, 2008 | ||
| Indirect Ownership Interest | Jan 1, 2008 | 100% | |
| Angela Smith | Operational/Managerial Control | Jun 13, 2024 | |
| Adp of the SNF | Jun 13, 2024 | ||
| Paul B Coburn | Adp of the SNF | Jan 1, 2008 | |
| Indirect Ownership Interest | Jan 1, 2008 | 50% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Shell Lake, WI
- NPI 1023010592
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapy Assistant
- Arcadia, LA
- NPI 1407348857
-
- Physical Therapy Assistant
- Arcadia, LA
- NPI 1306334081
-
- Speech-Language Pathologist
- Arcadia, LA
- NPI 1811484512
-
- Physical Therapist
- Arcadia, LA
- NPI 1912494980
-
- Occupational Therapy Assistant
- Arcadia, LA
- NPI 1316434004
-
- Family Medicine Physician
- Shell Lake, WI
- NPI 1023010592
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": "1154736000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1392336000000",
"number": "1962411355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1355 6TH ST",
"city": "ARCADIA",
"state": "LA",
"postal_code": "710013109",
"telephone_number": "318-263-9581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1355 6TH ST",
"city": "ARCADIA",
"state": "LA",
"postal_code": "710013109",
"telephone_number": "318-263-9581"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LESLIE LAKES CARE CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-05",
"last_updated": "2014-02-14",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "DAWNE",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "318-812-2140"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "LA",
"license": "859",
"primary": true
},
{
"code": "332BN1400X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "332BP3500X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1510653",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Leslie Lakes Retirement Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Arcadia, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.