POLK GROUP HOME (NPI# 1447275011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447275011 |
| Entity Type | Organization |
| Organization Name | POLK GROUP HOME |
| Practice Address |
557 Mckeithen Drive Alexandria LA 71303 |
| Mailing Address |
Po Box 7917 Alexandria LA 71306-0917 |
| Practice Telephone | 3184730212 |
| Practice Fax Number | 3184730117 |
| Mailing Telephone | 3184451551 |
| Mailing Fax Number | 3184451242 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2009-11-07 |
| Authorized Official Name | MS. CHRISTINA BONNETTE BOLTON (ADMINISTRATOR) |
| Authorized Official Telephone | 3184451551 |
| Is Organization Subpart | Y |
| Parent Organization Name | WESTSIDE HABILITATION CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 815 | LA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | UNISYS | 1713678 | 01 |
| LA | 19G531 | 05 |
| Street Address |
557 MCKEITHEN DRIVE |
| City | ALEXANDRIA |
| State | LA |
| Zip Code | 71303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346877370 | Victoria Bowie | Peer Specialist | 1405 Peterman Drive Suite A, Alexandria, LA 71303 | 2020-03-27 |
| 1396375051 | Christin Authement | Social Worker | 8326 Kelwood Avenue, Alexandria, LA 71303 | 2020-01-22 |
| 1164904520 | Carissa A Sorenson | Pharmacist | 4448 Jackson St, Alexandria, LA 71303 | 2018-09-02 |
| 1144731027 | Bradly Herman | Counselor | 1450 Peterman Drive, Alexandria, LA 71303 | 2017-10-18 |
| 1669991915 | Rashika Holmes | Counselor | 1538 Chase Dr, Alexandria, LA 71303 | 2017-09-18 |
| 1215466594 | Terraniecya Shepherd | Case Manager/Care Coordinator | 700 Veterans Dr. Apt. 608, Alexandria, LA 71303 | 2017-06-08 |
| 1427587864 | Jason Micheal Lachica | Counselor | 3921 Indpendence Drive Ste 104, Alexandria, LA 71303 | 2017-06-08 |
| 1669929188 | Ryan Knoll | Chiropractor | 5419 Jackson St. Ext. Suite B, Alexandria, LA 71303 | 2016-09-01 |
| 1023464393 | Heart of Hospice, LLC | Hospice Care, Community Based | 1001 Bayou Pl, Alexandria, LA 71303 | 2016-05-05 |
| 1770947764 | Jiquiah White | Counselor | 2016 Innis Dr, Alexandria, LA 71303 | 2016-04-06 |
| Find all providers in zip 71303 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1306089594 | Cleveland Community Home | Intermediate Care Facility, Mentally Retarded | 5621 Hera St, Alexandria, LA 71303-2212 | 2009-04-17 |
| 1174766364 | Roosevelt Community Home | Intermediate Care Facility, Mentally Retarded | 1605 Texas Ave, Alexandria, LA 71301-4050 | 2009-04-17 |
| 1437392628 | Mckinley Group Home | Intermediate Care Facility, Mentally Retarded | 6500 Masonic Dr, Alexandria, LA 71301-2321 | 2009-04-17 |
| 1013150200 | Taft Community Home | Intermediate Care Facility, Mentally Retarded | 4314 Whitefield Blvd, Alexandria, LA 71303-2925 | 2009-04-17 |
| 1548400617 | Garfield Group Home | Intermediate Care Facility, Mentally Retarded | 1263 Enterprise Road, Alexandria, LA 71303 | 2009-03-02 |
| 1225278427 | Harding Community Home | Intermediate Care Facility, Mentally Retarded | 520 Westwind Dr, Alexandria, LA 71303-3800 | 2009-02-27 |
| 1972755502 | Hayes Community Home | Intermediate Care Facility, Mentally Retarded | 3811 Lisa St, Alexandria, LA 71302-2520 | 2008-10-14 |
| 1033378781 | Taylor Group Home | Intermediate Care Facility, Mentally Retarded | 5635 Navaho Trl, Alexandria, LA 71301-2853 | 2008-06-07 |
| Find all providers in ALEXANDRIA | ||||
| City | ALEXANDRIA |
| Zip Code | 71303 |
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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.