LHCG XII, LLC (NPI# 1225534662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225534662 |
| Entity Type | Organization |
| Organization Name | LHCG XII, LLC |
| Other Organization Name | LOUISIANA EXTENDED CARE HOSPITAL OF LAFAYETTE |
| Practice Address |
2810 Ambassador Caffery Pkwy Fl 5 Lafayette LA 70506-5906 |
| Mailing Address |
Po Box 51266 Lafayette LA 70505-1266 |
| Practice Telephone | 3372898180 |
| Practice Fax Number | 3372335764 |
| Mailing Telephone | 3372331307 |
| Mailing Fax Number | 3372335764 |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2019-07-24 |
| Authorized Official Name | DONALD D. STELLY (PRESIDENT) |
| Authorized Official Telephone | 3372331307 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Louisiana Extended Care Hospital of Lafayette | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205207370 | Lhcg Xii, LLC | Hospitalist | 1214 Coolidge Blvd, 9th & 10th Floor, Lafayette, LA 70503-2621 | 2015-10-14 |
| Street Address |
2810 AMBASSADOR CAFFERY PKWY FL 5 |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70506-5906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417421447 | Maranda Washington | Student in an Organized Health Care Education/Training Program | 202 Reinhardt Drive, Lafayette, LA 70506 | 2019-01-12 |
| 1447742473 | Glenda Gravouilla Poulan | Driver | 330 Guilbeau Rd, Lafayette, LA 70506 | 2018-06-05 |
| 1194215905 | Angelica Plumbar | Case Manager/Care Coordinator | 1304 Bertrand Dr Ste B21304, Lafayette, LA 70506 | 2018-05-16 |
| 1801394820 | Acadiana Ambulatory Health Care Services | Non-Pharmacy Dispensing Site | 207 Westmark Blvd., Lafayette, LA 70506 | 2018-01-24 |
| 1578070041 | Kimberly Lois Robinson | Counselor | 203 Pinto St, Lafayette, LA 70506 | 2018-01-05 |
| 1558890814 | Shanece Marie Solomon | Speech-Language Pathologist | 326 Guilbeau Rd Apt 240, Lafayette, LA 70506 | 2017-06-08 |
| 1225565625 | Keena Lewis | Case Manager/Care Coordinator | 121 Kohen Luke Dr, Lafayette, LA 70506 | 2017-05-16 |
| 1326571498 | Natasha Deville | Community/Behavioral Health | 1408 W Willow St 162, Lafayette, LA 70506 | 2017-04-06 |
| 1952846826 | Mia D Arthur | Behavioral Analyst | 511 Monarch Dr, Lafayette, LA 70506 | 2016-12-30 |
| 1265983340 | Eric Prince | Specialist/Technologist | 202 Reinhardt Dr., Lafayette, LA 70506 | 2016-10-24 |
| Find all providers in zip 70506 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366843716 | Witham Memorial Hospital | Skilled Nursing Facility | 2402 South St, Lafayette, IN 47904-3063 | 2014-09-04 |
| 1912278391 | Jordan Russell Carver | Skilled Nursing Facility | 203 Mai Ridge Lane, Lafayette, TN 37083-4477 | 2012-01-18 |
| 1700118262 | Hancock Regional Hospital | Skilled Nursing Facility | 1750 S Creasy Ln, Lafayette, IN 47905-4911 | 2010-02-09 |
| 1538356936 | Cornerstone Village South, Inc | Skilled Nursing Facility | 103 W Martial Ave, Lafayette, LA 70508-6719 | 2007-09-28 |
| 1366520090 | Nurses Alliance Corporation | Skilled Nursing Facility | 1010 1st Street, Lafayette, CA 94549 | 2006-11-01 |
| 1699872879 | Tri-age Adventures, Inc. | Skilled Nursing Facility | 405 Times Ave, Lafayette, TN 37083-1247 | 2006-09-20 |
| 1649288572 | Andover Rehab Center Services Two Inc | Skilled Nursing Facility | 99 Mulford Road, Lafayette, NJ 07848 | 2006-08-04 |
| 1861420408 | Lafayette Nursing Home LLC | Skilled Nursing Facility | 555 B Street, Lafayette, AL 36862-0109 | 2006-06-30 |
| 1205878097 | Lafayette Extended Care | Skilled Nursing Facility | 805 Hospital St, Lafayette, AL 36862-2817 | 2006-06-13 |
| 1194764563 | Franciscan Communities, Inc. | Skilled Nursing Facility | 2201 Cason St, Lafayette, IN 47904-2613 | 2006-06-04 |
| Find all providers in LAFAYETTE | ||||
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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.