NPIMap

Organization Active NPI

Positive Change

  • Community/Behavioral Health Agency
  • Shreveport, LA
National Provider Identifier
1982079075
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
POSITIVE CHANGE
Practice address
351 W 79TH St
Shreveport, LA 71106-4819
Phone
(318) 688-8190
NPI assigned
Dec 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Authorized official

Name
Keesha Dinkins
Title
Business Manager
Phone
(318) 688-8190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

351 W 79TH St
Shreveport, LA 71106-4819

Mailing address

1100 W 70TH St
Apt 1401
Shreveport, LA 71106-3562
Phone (318) 572-7517

Other identifiers 1

IdentifierTypeStateIssuer
2395157MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Positive Change2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1982079075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W 70TH ST",
            "address_2": "APT 1401",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711063562",
            "telephone_number": "318-572-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 W 79TH ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711064819",
            "telephone_number": "318-688-8190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSITIVE CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "DINKINS",
        "authorized_official_first_name": "KEESHA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "318-688-8190"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2395157",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; 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.