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LEESVILLE DEVELOPMENTAL CENTER NPI 1194944124


NPI Information

NPI: 1194944124
Provider Name: LEESVILLE DEVELOPMENTAL CENTER

Doing Business As: RAY CHARLES SMITH COMMUNITY HOME

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
510 CURTIS ST
LEESVILLE, LA
ZIP 71446
Phone: (337) 238-6454
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LEESVILLE DEVELOPMENTAL CENTER is a community based residential treatment facility, intellectual and/or developmental disabilities in Leesville, LA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. LEESVILLE DEVELOPMENTAL CENTER NPI is 1194944124. The provider is registered as an organization entity type.
The provider Is Doing Business As Ray Charles Smith Community Home.

The provider's business location address is:

510 CURTIS ST
LEESVILLE, LA
ZIP 71446-806
Phone: (337) 238-6454

The provider's authorized official is Tommy Brooks .
The authorized official title is Facility Services Director and has the following contact phone number (337) 239-2687.

The enumeration date for this NPI number is 4/25/2007 and was last updated on 6/18/2008.


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
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities698LOUISIANAYes

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 Other Provider Identifier Issuer
11712272MEDICAIDLOUISIANA

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: 5/5/2024

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