CDF HEALTHCARE OF LA, LLC (NPI# 1205051711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205051711 |
Entity Type | Organization |
Organization Name | CDF HEALTHCARE OF LA, LLC |
Other Organization Name | SOUTHFORK GROUP HOME |
Practice Address |
149 Afton Rd Tallulah LA 71282-7455 |
Mailing Address |
Po Box 607 Delhi LA 71232-0607 |
Practice Telephone | 3185740704 |
Mailing Telephone | 3188785106 |
Mailing Fax Number | 3188788671 |
Enumeration Date | 2007-04-17 |
Last Update Date | 2010-06-09 |
Authorized Official Name | MR. JOE DEBOLT (ADMINISTRATOR) |
Authorized Official Telephone | 3188785106 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 978 | LA | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
LA | 1719668 | 05 |
Other Name | Type Code |
---|---|
Southfork Group Home | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326304445 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 596 Midway Church Lane, Delhi, LA 71232 | 2012-04-03 |
1801196084 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 4449 Highway 17, Delhi, LA 71232 | 2010-10-22 |
1538477450 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 606 Midway Church Lane, Delhi, LA 71232 | 2010-09-14 |
1396065595 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 668 Midway Church Road, Delhi, LA 71232 | 2010-06-10 |
1669796447 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 652 Midway Church Lane, Delhi, LA 71232 | 2010-03-23 |
1346578069 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 80 Teer St, Delhi, LA 71232 | 2009-11-19 |
1962736967 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 98 Teer St, Delhi, LA 71232 | 2009-09-23 |
1902046485 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 128 College Rd, Delhi, LA 71232-7042 | 2009-02-24 |
1467699371 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 126 College Rd, Delhi, LA 71232-7042 | 2009-01-14 |
1669623591 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 204 Hall St, Delhi, LA 71232-2237 | 2008-10-09 |
Street Address |
149 AFTON RD |
City | TALLULAH |
State | LA |
Zip Code | 71282-7455 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982211140 | Adonis Williams | Counselor | 410 E Askew Street, Tallulah, LA 71282 | 2020-09-30 |
1154957272 | Renewed Path Counseling Services LLC | Community/Behavioral Health | 602 Wood St Suite A, Richmond, LA 71282 | 2020-03-20 |
1639632136 | Ljconsulting & Professional Services, LLC | Counselor | 809 Bailey Rd., Tallulah, LA 71282 | 2019-04-11 |
1982120937 | Chryl Smith Lee | Counselor | 1705 W Feliciana Ave, Talullah, LA 71282 | 2017-08-21 |
1730619347 | Carmen Larae Allen | Counselor | 805 N Beech Street, Tallulah, LA 71282 | 2017-06-15 |
1205365665 | Brittney Vontres Scott | Case Manager/Care Coordinator | 1705 Felicia Avenue, Tallulah, LA 71282 | 2017-06-08 |
1427500123 | Sharon Jackson | Case Manager/Care Coordinator | 1000 S Elm St, Tallulah, LA 71282 | 2016-10-28 |
1982152989 | John Tanner Mcdonald | Pharmacist | 402 East Darrow Street, Tallulah, LA 71282 | 2016-09-19 |
1164874350 | Victor Lewis Jr. | Counselor | 1705 Felicia Drive, Tallulah, LOUISIANA 71282 | 2016-07-12 |
1356797492 | Keisha Prosser | Case Manager/Care Coordinator | 1705 Felicia Aveune, Tallulah, LA 71282 | 2016-05-08 |
Find all providers in zip 71282 |
Taxonomy Code | 315P00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Intermediate Care Facility, Mentally Retarded |
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437374949 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 112 Wallace Rd, Tallulah, LA 71282-7438 | 2007-04-17 |
1790901205 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 100 Caroline St, Tallulah, LA 71282-5508 | 2007-04-17 |
1982820494 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 618 E Darrow St, Tallulah, LA 71282-3516 | 2007-04-17 |
1639392996 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 613 Verhagen Rd, Tallulah, LA 71282-7445 | 2007-04-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174136527 | St. Mary's Residential Training School | Intermediate Care Facility, Mentally Retarded | 1901 Huie Dellmon Ave, Boyce, LA 71409-9329 | 2020-08-26 |
1174136535 | St. Mary's Residential Training School | Intermediate Care Facility, Mentally Retarded | 1903 Huie Dellmon Ave, Boyce, LA 71409-9329 | 2020-08-26 |
1427613371 | Lisa Williams | Intermediate Care Facility, Mentally Retarded | 1202 St. Maurice Ave, New Orleans, LA 70117-7011 | 2019-05-07 |
1700324084 | Magnolia Community Services, Inc | Intermediate Care Facility, Mentally Retarded | 821 Jefferson Heights Ave., Jefferson, LA 70121 | 2017-02-07 |
1801260468 | Magnolia Community Services, Inc | Intermediate Care Facility, Mentally Retarded | 143 Central Ave, Jefferson, LA 70121-3401 | 2015-11-19 |
1669867545 | Wendover Community Home | Intermediate Care Facility, Mentally Retarded | 4607 Wendover Blvd, Alexandria, LA 71303-2528 | 2015-03-30 |
1538554423 | West Pointe Community Home | Intermediate Care Facility, Mentally Retarded | 6218 W Pointe Blvd, Alexandria, LA 71303-2000 | 2015-03-30 |
1073904389 | Normal Life of Louisiana, Inc. | Intermediate Care Facility, Mentally Retarded | 15460 Tracey Ln, Independence, LA 70443-2470 | 2015-02-09 |
1306276639 | The Arc of Sabine Inc | Intermediate Care Facility, Mentally Retarded | 200 Dockens Dr, Many, LA 71449-3852 | 2013-11-22 |
1326304445 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 596 Midway Church Lane, Delhi, LA 71232 | 2012-04-03 |
Find all providers with the same taxonomy |
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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.