PINECREST DEVELOPMENTAL CENTER NPI 1336367085

NPI Information

  • NPI: 1336367085
  • Provider Name: PINECREST DEVELOPMENTAL CENTER
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Doing Business As: EDGEWOOD COMMUNITY HOME
  • Address: 100 PINECREST DRIVE
    PINEVILLE, LA
    ZIP 71361
  • Phone: (318) 641-2000

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NPI Details

PINECREST DEVELOPMENTAL CENTER is a community based residential treatment facility, intellectual and/or developmental disabilities in Pineville, 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. PINECREST DEVELOPMENTAL CENTER NPI is 1336367085. The provider is registered as an organization entity type.
The provider Is Doing Business As Edgewood Community Home.

The provider's business location address is:

100 PINECREST DRIVE
PINEVILLE, LA
ZIP 71361
Phone: (318) 641-2000
Fax: (318) 641-2309

The provider's authorized official is Sherri A Evans .
The authorized official title is Mr Dd Regional Administrator and has the following contact phone number (318) 641-2003.

The enumeration date for this NPI number is 4/20/2007 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 Disabilities955LOUISIANAYes

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
11712388MEDICAIDLOUISIANA

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: 11/21/2025

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