CLD Inc
Organization Active NPI Skilled Nursing Facility · Coushatta, LA
NPI 1992743538 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1992743538
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 224 (LA)
- Legal business name
- CLD INC
- Practice address
- 1110 Ringgold Ave
Coushatta, LA 71019-9073 - Phone
- (318) 932-5202
- Fax
- (318) 932-3034
- NPI assigned
- Jun 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Lawrence Bingham
- Title
- Owner
- Phone
- (318) 932-5202
Corporate family (same tax ID) 1
Practitioners 1
-
Gavin F Chico, M. D.
Affiliated clinicians 2
-
Gavin F Chico, M. D.
-
Wyche Taylor Coleman Jr., M.D.
Medicare Care Compare: Nursing home
- Listed as
- Green Meadow Haven
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Oct 18, 2002
- Medicare certification status
- Active
- Certified beds
- 157 · 83.4 residents per day on average
- Penalties (3 years)
- 2 · fines totaling $8,278
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Skilled nursing facility certification: CCN 195562
- Legal name
- CLD INC
- Doing business as
- GREEN MEADOW HAVEN
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 18, 2002
- Last certification
- Jul 24, 2024
- Beds
- 157
- Ownership / control type
- Corporation
- Organization structure
- Corporation · Proprietary
- Enrollment address
- 1110 Ringgold Ave
Coushatta, LA 71019-9073 - Nursing home name
- GREEN MEADOW HAVEN
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Carla Bingham |
5% Or Greater Direct Ownership Interest | Dec 29, 1998 | 9.16% |
| Corporate Director |
Dec 29, 1998 | ||
| Sharon Redd |
5% Or Greater Direct Ownership Interest | Dec 29, 1998 | 11.11% |
| Corporate Director |
Dec 29, 1998 | ||
| Gabriel Reynolds |
Corporate Officer |
Jan 1, 2016 | |
| Operational/Managerial Control | Jan 1, 2016 | ||
| Adp of the SNF | Jan 1, 2016 | ||
| Tammie Sistrunk |
5% Or Greater Direct Ownership Interest | Dec 29, 1998 | 16.67% |
| Corporate Director |
Dec 29, 1998 | ||
| Donnice Reynolds |
5% Or Greater Direct Ownership Interest | Dec 29, 1998 | 16.67% |
| Corporate Officer |
Dec 29, 1998 | ||
| Doris Dupree |
5% Or Greater Direct Ownership Interest | Dec 29, 1998 | 11.11% |
| Corporate Director |
Dec 29, 1998 | 11.11% | |
| Pamela Lancaster |
5% Or Greater Direct Ownership Interest | Dec 29, 1998 | 10% |
| Corporate Director |
Dec 29, 1998 | ||
| Valerie Bingham |
5% Or Greater Direct Ownership Interest | Dec 29, 1998 | 9.16% |
| Corporate Director |
Dec 29, 1998 | ||
| Teresa Vidrine |
5% Or Greater Direct Ownership Interest | Dec 29, 1998 | 11.11% |
| Corporate Director |
Dec 29, 1998 | ||
| John Lancaster |
5% Or Greater Direct Ownership Interest | Dec 29, 1998 | 5% |
| Corporate Director |
Dec 29, 1998 | 5% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091222000081 | LA | Part a Provider - Skilled Nursing Facility | 4880734961 | Practice locations: Coushatta, LA |
National Provider Directory
- Tax ID family
- CLD Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 224 | LA | Yes |
Addresses
Primary practice location
1110 Ringgold Ave
Coushatta, LA 71019-9073
Mailing address
1110 Ringgold Ave
Coushatta, LA 71019-9073
Phone (318) 932-5202
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52047 | Medicaid | LA |
Other names
- GREEN MEADOW HAVEN
NPI Registry JSON
{
"created_epoch": "1149379200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1992743538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 RINGGOLD AVE",
"city": "COUSHATTA",
"state": "LA",
"postal_code": "710199073",
"telephone_number": "318-932-5202",
"fax_number": "318-932-3034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 RINGGOLD AVE",
"city": "COUSHATTA",
"state": "LA",
"postal_code": "710199073",
"telephone_number": "318-932-5202",
"fax_number": "318-932-3034"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLD INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-04",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BINGHAM",
"authorized_official_first_name": "LAWRENCE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "318-932-5202",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "LA",
"license": "224",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "52047",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "GREEN MEADOW HAVEN",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Coushatta, LA
- Christus Health Central Louisiana
- Christus Health Central Louisiana
- Christus Health Central Louisiana
- Christus Health Central Louisiana
- Christus Health Central Louisiana
- Thomas William Coleman
- Wyche Taylor Coleman Jr.
- Laura Elizabeth Colvin
- Community Rehabilitation Hospital of Coushatta
- James Merrill Conly
All providers in Coushatta, 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 Aug 22, 2020. 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.