HOLY ANGELS RESIDENTIAL FACILITY (NPI# 1184843849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184843849 |
| Entity Type | Organization |
| Organization Name | HOLY ANGELS RESIDENTIAL FACILITY |
| Practice Address |
10450 Ellerbe Rd Shreveport LA 71106-7712 |
| Practice Telephone | 3187978500 |
| Practice Fax Number | 3187980159 |
| Mailing Telephone | 3187978500 |
| Mailing Fax Number | 3187980159 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CONCETTA SCIPIONE (ADMINISTRATOR) |
| Authorized Official Telephone | 3187978500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | 913 | LA | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477633014 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2006-10-17 |
| 1578014387 | Holy Angels Residential Facility | Community/Behavioral Health | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2016-10-17 |
| 1124578174 | Holy Angels Residential Facility | Day Training, Developmentally Disabled Services | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2016-10-13 |
| 1861747636 | Holy Angels Residential Facility | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2012-07-18 |
| 1770750747 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2008-05-09 |
| 1639345853 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2008-05-07 |
| 1992924658 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1982823654 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1225256035 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1619196383 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| Street Address |
10450 ELLERBE RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-7712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477633014 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2006-10-17 |
| 1710471891 | Scott M Lepley | Behavioral Analyst | 10450 Ellerbe Rd, Shreveport, LA 71106-7730 | 2018-06-21 |
| 1699215343 | Mary O'neal | Behavioral Analyst | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2017-02-28 |
| 1578014387 | Holy Angels Residential Facility | Community/Behavioral Health | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2016-10-17 |
| 1124578174 | Holy Angels Residential Facility | Day Training, Developmentally Disabled Services | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2016-10-13 |
| 1497173090 | Angelworks Adult Day Center | Day Training, Developmentally Disabled Services | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2014-04-01 |
| 1861747636 | Holy Angels Residential Facility | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2012-07-18 |
| 1770750747 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2008-05-09 |
| 1639345853 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2008-05-07 |
| 1992924658 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992924658 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1982823654 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1225256035 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1619196383 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1528287299 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1437378106 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1346469012 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1164641833 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1073732749 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1316165418 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-23 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
Please comment or provide details below to improve the information on HOLY ANGELS RESIDENTIAL FACILITY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.