AMENA HEALTHCARE GROUP LLC (AMENA ADULT DAY & CHILDREN REHAB SERVICES) - NPI NUMBER 1386088417

Summary

Provider Name: AMENA HEALTHCARE GROUP LLC (AMENA ADULT DAY & CHILDREN REHAB SERVICES)

NPI Number: 1386088417

Clasification: Day Training, Developmentally Disabled Services (251C00000X)

Address:
5329 DIJON DR
STE 107
BATON ROUGE, LA
ZIP 70808

Phone Number: (225) 761-5070



Detailed Information

AMENA HEALTHCARE GROUP LLC is a day training, developmentally disabled services in Baton Rouge, LA. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. The assigned NPI number for this provider is 1386088417 and is registered as an organization entity type.
The provider Is Doing Business As Amena Adult Day & Children Rehab Services.

The provider's business address is:

5329 DIJON DR
STE 107
BATON ROUGE, LA
ZIP 70808-378
Phone: (225) 761-5070
Fax: (225) 766-0773

The provider's authorized official is Rhonda Johnson .
The authorized official title is Owner and has the following contact phone number (225) 588-8111.

The enumeration date for this NPI number is 4/19/2013 and was last updated on 2/18/2015.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 251C00000X Day Training, Developmentally Disabled Services No
2 251S00000X Community/Behavioral Health Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1386088417 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name AMENA HEALTHCARE GROUP LLC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name AMENA ADULT DAY & CHILDREN REHAB SERVICES Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 5329 DIJON DR The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Second Line Business Practice Location Address STE 107 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name BATON ROUGE The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name LA The city name in the location address of the provider being identified.
11 Provider Business Practice Location Address Postal Code 708084378 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
13 Provider Business Practice Location Address Telephone Number 2257615070 The telephone number associated with the location address of the provider being identified.
14 Provider Business Practice Location Address Fax Number 2257660773 The fax number associated with the location address of the provider being identified.
15 Provider Enumeration Date 4/19/2013 The date the provider was assigned a unique identifier (assigned an NPI).
16 Last Update Date 2/18/2015 The date that a record was last updated or changed.
17 Authorized Official Last Name JOHNSON The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
18 Authorized Official First Name RHONDA The first name of the authorized official.
19 Authorized Official Title or Position OWNER The title or position of the authorized official.
20 Authorized Official Telephone Number 2255888111 The 10-position telephone number of the authorized official.
21 Healthcare Provider Taxonomy Code 1 251C00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
22 Healthcare Provider Primary Taxonomy Switch 1 N The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
23 Healthcare Provider Taxonomy Code 2 251S00000X
24 Healthcare Provider Primary Taxonomy Switch 2 Y Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
25 Is Organization Subpart N

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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