NPIMap

Organization Active NPI

Holy Angels Residential Facility

  • Intellectual Disabilities Intermediate Care Facility
  • Shreveport, LA
National Provider Identifier
1992924658
Registry record updated Jun 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
HOLY ANGELS RESIDENTIAL FACILITY
Practice address
10450 Ellerbe Rd
Shreveport, LA 71106-7712
Phone
(318) 797-8500
Fax
(318) 798-0159
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2022

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

Authorized official

Name
Christina Landry Horne, CPA
Title
Director of Finance
Phone
(318) 797-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

10450 Ellerbe Rd
Shreveport, LA 71106-7712

Mailing address

10450 Ellerbe Rd
Shreveport, LA 71106-7712
Phone (318) 797-8500

Other identifiers 1

IdentifierTypeStateIssuer
1710920MedicaidLA

Other names 1

  • Edna Marie Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Holy Angels Residential Facility23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1992924658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 ELLERBE RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067712",
            "telephone_number": "318-797-8500",
            "fax_number": "318-798-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 ELLERBE RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067712",
            "telephone_number": "318-797-8500",
            "fax_number": "318-798-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLY ANGELS RESIDENTIAL FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "HORNE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "LANDRY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "318-797-8500",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710920",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edna Marie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 13, 2022; 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.