HOLY ANGELS RESIDENTIAL FACILITY (NPI# 1578014387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578014387 |
| Entity Type | Organization |
| Organization Name | HOLY ANGELS RESIDENTIAL FACILITY |
| Other Organization Name | HOLY ANGELS AUTISM CENTER |
| Practice Address |
10450 Ellerbe Rd Shreveport LA 71106-7712 |
| Practice Telephone | 3187978500 |
| Practice Fax Number | 3187970801 |
| Mailing Telephone | 3187978500 |
| Mailing Fax Number | 3187970801 |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |
| Authorized Official Name | MRS. LAURIE FAITH BOSWELL (CEO) |
| Authorized Official Telephone | 3187978500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | LA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1619196383 | 05 | |
| LA | 1861747636 | 05 | |
| LA | 1184843849 | 05 | |
| LA | 1770750747 | 05 | |
| LA | 1073732749 | 05 | |
| LA | 1528287299 | 05 | |
| LA | 1992924658 | 05 | |
| LA | 1437378106 | 05 | |
| LA | 1497173090 | 05 | |
| LA | 1164641833 | 05 | |
| LA | 1316165418 | 05 | |
| LA | 1346469012 | 05 | |
| LA | 1225256035 | 05 | |
| LA | 1639345853 | 05 | |
| LA | 1982823654 | 05 |
| Other Name | Type Code |
|---|---|
| Holy Angels Autism Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477633014 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2006-10-17 |
| 1124578174 | Holy Angels Residential Facility | Day Training, Developmentally Disabled Services | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2016-10-13 |
| 1861747636 | Holy Angels Residential Facility | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2012-07-18 |
| 1770750747 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2008-05-09 |
| 1639345853 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2008-05-07 |
| 1184843849 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1992924658 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1982823654 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1225256035 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1619196383 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| Street Address |
10450 ELLERBE RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-7712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477633014 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2006-10-17 |
| 1710471891 | Scott M Lepley | Behavioral Analyst | 10450 Ellerbe Rd, Shreveport, LA 71106-7730 | 2018-06-21 |
| 1699215343 | Mary O'neal | Behavioral Analyst | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2017-02-28 |
| 1124578174 | Holy Angels Residential Facility | Day Training, Developmentally Disabled Services | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2016-10-13 |
| 1497173090 | Angelworks Adult Day Center | Day Training, Developmentally Disabled Services | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2014-04-01 |
| 1861747636 | Holy Angels Residential Facility | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2012-07-18 |
| 1770750747 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2008-05-09 |
| 1639345853 | Holy Angels Residential Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2008-05-07 |
| 1184843849 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| 1992924658 | Holy Angels Residential Facility | Intermediate Care Facility, Mental Illness | 10450 Ellerbe Rd, Shreveport, LA 71106-7712 | 2007-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558926113 | Renew Therapeutic Services, LLC | Community/Behavioral Health | 2924 Knight St Ste 424, Shreveport, LA 71105-2413 | 2019-05-08 |
| 1053818641 | Agape Love Counseling Service LLC | Community/Behavioral Health | 1513 Line Ave Ste 240, Shreveport, LA 71101-4621 | 2018-04-10 |
| 1851891865 | Magnolia Mental Health LLC | Community/Behavioral Health | 7629 Pines Rd, Shreveport, LA 71129-3905 | 2018-02-15 |
| 1891202776 | Allcare of Louisiana, Inc. | Community/Behavioral Health | 4615 Monkhouse Dr Ste 116, Shreveport, LA 71109-6123 | 2018-01-02 |
| 1467979708 | Finding A Better Me | Community/Behavioral Health | 2924 Knight St Ste 420, Shreveport, LA 71105-2413 | 2017-08-28 |
| 1518495779 | Bridges To Recovery, LLC | Community/Behavioral Health | 7607 Fern Ave Ste 902-903, Shreveport, LA 71105-5739 | 2017-05-31 |
| 1790210805 | Acenter for Hope and Change | Community/Behavioral Health | 6811 Sagewood Dr, Shreveport, LA 71129-9423 | 2017-04-26 |
| 1497289979 | Serenity Behavioral Health Service LLC | Community/Behavioral Health | 2000 Creswell Ave, Shreveport, LA 71104-2202 | 2017-04-12 |
| 1699212696 | Shenells | Community/Behavioral Health | 2120 N Hearne Ave Apt 403, Shreveport, LA 71107-7183 | 2017-01-27 |
| 1669918199 | Street Outreach Solutions,llc | Community/Behavioral Health | 2715 Mackey Pl Ste 119, Shreveport, LA 71118-2527 | 2017-01-08 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
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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.