CERTICAREINC NPI 1205995792

NPI Information

  • NPI: 1205995792
  • Provider Name: CERTICAREINC
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Address: 413 S FARMERVILLE ST
    RUSTON, LA
    ZIP 71270
  • Phone: (318) 255-1077

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NPI Details

CERTICAREINC is a community based residential treatment facility, intellectual and/or developmental disabilities in Ruston, 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. CERTICAREINC NPI is 1205995792. The provider is registered as an organization entity type.

The provider's business location address is:

413 S FARMERVILLE ST
RUSTON, LA
ZIP 71270-654
Phone: (318) 255-1077

The provider's authorized official is Michael Dwaine Douglas .
The authorized official title is Presiden and has the following contact phone number (318) 255-1077.

The enumeration date for this NPI number is 12/8/2006 and was last updated on 8/22/2020.

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 DisabilitiesYes

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
11773662MEDICAIDLOUISIANA
21462870MEDICAIDLOUISIANA
31773212MEDICAIDLOUISIANA
41123609MEDICAIDLOUISIANA
51123625MEDICAIDLOUISIANA
61773620MEDICAIDLOUISIANA

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: 3/30/2025

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