MADISON GROUP HOME NPI 1689726143

NPI Information

NPI: 1689726143
Provider Name: MADISON GROUP HOME
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
1315 PRESIDENTS DRIVE
ALEXANDRIA, LA
ZIP 71303
Phone: (318) 443-7552
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MADISON GROUP HOME is an intermediate care facility mentally retarded in Alexandria, LA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. MADISON GROUP HOME NPI is 1689726143. The provider is registered as an organization entity type.

The provider's business location address is:

1315 PRESIDENTS DRIVE
ALEXANDRIA, LA
ZIP 71303
Phone: (318) 443-7552
Fax: (318) 443-7553

The provider's authorized official is Christina Bonnette Bolton .
The authorized official title is Administrator and has the following contact phone number (318) 445-1551.

The enumeration date for this NPI number is 1/17/2007 and was last updated on 11/7/2009.

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		947	LOUISIANA	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	Other Provider Identifier Issuer
1	1099325	OTHER	LOUISIANA	UNISYS
2	19G575	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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