HOLY ANGELS RESIDENTIAL FACILITY NPI 1437378106

NPI Information

NPI: 1437378106
Provider Name: HOLY ANGELS RESIDENTIAL FACILITY

Doing Business As: WILD OAK

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
10450 ELLERBE RD
SHREVEPORT, LA
ZIP 71106
Phone: (318) 797-8500
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HOLY ANGELS RESIDENTIAL FACILITY is an intermediate care facility mentally retarded in Shreveport, LA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. HOLY ANGELS RESIDENTIAL FACILITY NPI is 1437378106. The provider is registered as an organization entity type.
The provider Is Doing Business As Wild Oak.

The provider's business location address is:

10450 ELLERBE RD
SHREVEPORT, LA
ZIP 71106-712
Phone: (318) 797-8500
Fax: (318) 798-0159

The provider's authorized official is Christina Landry Horne .
The authorized official title is Director Of Finance and has the following contact phone number (318) 797-8500.

The enumeration date for this NPI number is 4/24/2007 and was last updated on 5/27/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	1073732749	MEDICAID	LOUISIANA
2	1346469012	MEDICAID	LOUISIANA
3	1497173090	MEDICAID	LOUISIANA
4	1639345853	MEDICAID	LOUISIANA
5	1316165418	MEDICAID	LOUISIANA
6	1437378106	MEDICAID	LOUISIANA
7	1578014387	MEDICAID	LOUISIANA
8	1770750747	MEDICAID	LOUISIANA
9	1619196383	MEDICAID	LOUISIANA
10	1982823654	MEDICAID	LOUISIANA
11	1184843849	MEDICAID	LOUISIANA
12	1861747636	MEDICAID	LOUISIANA
13	1164641833	MEDICAID	LOUISIANA
14	1225256035	MEDICAID	LOUISIANA
15	1528287299	MEDICAID	LOUISIANA
16	1992924658	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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