PINECREST DEVELOPMENTAL CENTER (NPI# 1336367085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336367085 |
| Entity Type | Organization |
| Organization Name | PINECREST DEVELOPMENTAL CENTER |
| Other Organization Name | EDGEWOOD COMMUNITY HOME |
| Practice Address |
100 Pinecrest Drive Pineville LA 71361 |
| Mailing Address |
Po Box 5191 Pineville LA 71361-5191 |
| Practice Telephone | 3186412000 |
| Practice Fax Number | 3186412309 |
| Mailing Telephone | 3186412000 |
| Mailing Fax Number | 3186412309 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SHERRI A EVANS (MR DD REGIONAL ADMINISTRATOR) |
| Authorized Official Telephone | 3186412003 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 955 | LA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1712388 | 05 |
| Other Name | Type Code |
|---|---|
| Edgewood Community Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215172549 | Pinecrest Developmental Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 Angelina Drive, Leesville, LA 71446 | 2008-12-16 |
| 1679756324 | Pinecrest Developmental Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5602 Mar Bud Trace, Pineville, LA 71361 | 2007-12-17 |
| 1306062328 | Pinecrest Developmental Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 511 Kimball Ave, Alexandria, LA 71301-5005 | 2007-04-18 |
| 1457576977 | Pinecrest Developmental Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3207 Madonna Dr, Alexandria, LA 71301-4816 | 2007-04-17 |
| 1598980096 | Pinecrest Developmental Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 528 Bob White Ln, Alexandria, LA 71303-2415 | 2007-04-17 |
| 1114143674 | Pinecrest Developmental Center | Day Training, Developmentally Disabled Services | 2969 Highway 28 E, Pineville, LA 71360-5716 | 2007-04-17 |
| 1881974749 | Pinecrest Developmental Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2006 Gus Kaplan Dr, Alexandria, LA 71301-3376 | 2011-08-24 |
| 1952614190 | Pinecrest Developmental Center | Clinic/Center | 2006 Gus Kaplan Dr, Alexandria, LA 71301-3376 | 2010-07-16 |
| 1174852875 | Pinecrest Developmental Center | Clinic/Center | 100 Pinecrest Dr, Attn: Paxton Oliver, Pineville, LA 71360-4276 | 2009-12-09 |
| 1316198575 | Pinecrest Developmental Center | Early Intervention Provider Agency | 100 Pinecrest Dr, Pineville, LA 71360-4276 | 2008-10-07 |
| Street Address |
100 PINECREST DRIVE |
| City | PINEVILLE |
| State | LA |
| Zip Code | 71361 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982754933 | Gaylon Murrell Bates | Pediatrics | 100 Pinecrest Drive, Pinecrest Develomental Center, Pineville, LA 71361-5191 | 2007-01-11 |
| 1568688513 | Pinecrest Develpmental Center | Community/Behavioral Health | 100 Pinecrest Drive, Pineville, LA 71361 | 2007-04-18 |
| 1740406339 | Pinecrest Developmental Center | Community/Behavioral Health | 100 Pinecrest Drive, Pineville, LA 71351 | 2007-04-18 |
| 1558586230 | Pinecrest Developmental Center | Long Term Care Hospital | 100 Pinecrest Drive, Pineville, LA 71361-5191 | 2007-04-16 |
| 1366564163 | Pinecrest Developmental Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 Pinecrest Drive, Pineville, LA 71360 | 2007-04-04 |
| 1669522538 | Frank Nmi Pearce IIi | Family Medicine | 100 Pinecrest Drive, Pineville, LA 71361 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578937397 | David Brocato | Counselor | 401 West Shamrock, Pineville, LA 71361 | 2015-11-17 |
| 1679756324 | Pinecrest Developmental Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5602 Mar Bud Trace, Pineville, LA 71361 | 2007-12-17 |
| 1013185891 | Marcos Donald Castrillo | Counselor | 242 W. Shamrock, Pineville, LA 71361 | 2008-02-14 |
| 1548447998 | John Rodney Crawford | Counselor | 242 W. Shamrock, Pineville, LA 71361 | 2008-01-29 |
| 1669690301 | Pinecrest Develpmental Center | Community/Behavioral Health | 100 Pinecrest Dr, Pineville, LA 71361 | 2007-04-20 |
| 1790715738 | Eagle Radiology LLC | Radiology | 352 Hospital Blvd, Pineville, LA 71361 | 2006-07-04 |
| 1831567718 | Victory Christian Outreach Center | Non-emergency Medical Transport (VAN) | 3523 Rigolette Rd., Pineville, LA 71361-4572 | 2015-09-09 |
| 1447302831 | Don Gray Mcdowell | Anesthesiology | 100 Pincrest Dr, Pinecrest Developmental Center, Pineville, LA 71361-5191 | 2007-01-17 |
| 1134208747 | Martin Lacour | Specialist | 352 Hospital Boulevard, Pineville, LA 71361-5352 | 2006-11-03 |
| 1043320765 | Alejandro Penzo | Internal Medicine | 352 Hospital Blvd., Pineville, LA 71361-5352 | 2006-08-30 |
| Find all providers in zip 71361 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417120536 | Colwell Interest, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1621 Susek Dr, Pineville, LA 71360-5483 | 2008-04-09 |
| 1942488341 | L.e.a. & A, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2560 Hickory Hill Rd, Pineville, LA 71360-7348 | 2008-02-07 |
| 1679756324 | Pinecrest Developmental Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5602 Mar Bud Trace, Pineville, LA 71361 | 2007-12-17 |
| 1912211525 | Colwell Health Services, Limited Liability Company | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 600 Edgewood Dr, Pineville, LA 71360-4527 | 2010-08-06 |
| 1194879569 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 920 Main St, Pineville, LA 71360-6408 | 2007-01-23 |
| 1326192634 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 920 Main St, Pineville, LA 71360-6408 | 2007-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417570847 | Foundation for You Community Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 525 Sibley St, Natchitoches, LA 71457-4420 | 2020-05-20 |
| 1114556412 | Grelan Muse | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3347 N Foster Dr, Baton Rouge, LA 70805-6825 | 2020-04-07 |
| 1619506912 | Lejune's Enterprises LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5720 Saint Gerard Ave, Baton Rouge, LA 70805-3753 | 2020-04-07 |
| 1912545567 | Safecare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 403 Willow St, Franklin, LA 70538-6022 | 2019-12-13 |
| 1528613049 | Arc of Acadiana, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 608 Lisa St, Rayne, LA 70578-7056 | 2019-08-02 |
| 1578118097 | Arc of Acadiana, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1900 Electa St, Rayne, LA 70578-7056 | 2019-08-02 |
| 1831686435 | Abiding In The Vine Care Provider | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1141 Whitney Ave Bldg 2, Gretna, LA 70056-5011 | 2018-04-18 |
| 1720539299 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15212 Wadesboro Dr., Ponchatoula, LA 70454 | 2016-10-20 |
| 1770931503 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24345 Harvey Lavigne Road, Ponchatoula, LA 70454 | 2016-06-02 |
| 1265880488 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3622 Groom Road, Baker, LA 70714 | 2016-05-27 |
| 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.