COMMUNITY BRIDGES WEST, INC. (NPI# 1386770162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386770162 |
| Entity Type | Organization |
| Organization Name | COMMUNITY BRIDGES WEST, INC. |
| Other Organization Name | GRACE HOME |
| Practice Address |
115 Sherwood Dr Benton LA 71006-9701 |
| Mailing Address |
Po Box 715 Ruston LA 71273-0715 |
| Practice Telephone | 3182559137 |
| Practice Fax Number | 3182558233 |
| Mailing Telephone | 3182559137 |
| Mailing Fax Number | 3182558233 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MIKE L. REYNOLDS (CEO) |
| Authorized Official Telephone | 3182559137 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 897 | LA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1718424 | 05 |
| Other Name | Type Code |
|---|---|
| Grace Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134255912 | Community Bridges West, Inc. | Intermediate Care Facility, Mentally Retarded | 1215 S Maple St, Ruston, LA 71270-5127 | 2007-02-26 |
| 1255467031 | Community Bridges West, Inc. | Intermediate Care Facility, Mentally Retarded | 2515 Brownlee Rd, Bossier City, LA 71111-2011 | 2007-02-26 |
| 1467692137 | Community Bridges West, Inc. | In Home Supportive Care | 1201 Atkins Rd, Ruston, LA 71270-8717 | 2009-02-20 |
| 1326288002 | Community Bridges West, Inc. | Case Management | 1201 Atkins Rd, Ruston, LA 71270-8717 | 2009-02-20 |
| Street Address |
115 SHERWOOD DR |
| City | BENTON |
| State | LA |
| Zip Code | 71006-9701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450517 | Just Health | Clinic/Center | 7076 La-3, Benton, LA 71006 | 2020-06-02 |
| 1982819678 | Robert Carroll Denmon | Pharmacist | 5604 Hwy 3, Freds Pharmacy # 1534, Benton, LA 71006 | 2007-05-14 |
| 1326174202 | David W Loftin | Pharmacist | 5604 Benton Rd, Benton, LA 71006 | 2007-02-26 |
| 1720163587 | Wayne Holden Marionneaux | Dentist | 192 Burt Blvd, Bentone, LA 71006 | 2006-10-27 |
| 1558478925 | Freds Stores of Tennessee Inc | Pharmacy | 5604 Hwy 3, Benton, LA 71006 | 2006-08-23 |
| 1861404683 | Rolling Rehab LLC | Physical Therapist | 115 Hunt Rd, Benton, LA 71006-3469 | 2006-08-12 |
| 1932327608 | Shanna D. Johnson | Physical Therapist | 115 Hunt Rd, Benton, LA 71006-3469 | 2007-04-20 |
| 1194134452 | Margaret B Rutledge | Social Worker | 2018 Pine Ridge Way, Benton, LA 71006-3488 | 2014-08-11 |
| 1942373410 | Brookshire Grocery Company | Pharmacy | 6280 Highway 3, Attention Pharmacy Dept, Benton, LA 71006-3492 | 2006-11-15 |
| 1669854253 | Dao B Kha | Pharmacist | 6280 Highway 3, Benton, LA 71006-3492 | 2015-06-19 |
| Find all providers in zip 71006 | ||||
| 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 |
|---|---|---|---|---|
| 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.