COLONIAL LIVING CENTER, LLC (NPI# 1720085723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720085723 |
| Entity Type | Organization |
| Organization Name | COLONIAL LIVING CENTER, LLC |
| Other Organization Name | COLONIAL OAKS LIVING CENTER |
| Practice Address |
4312 Ithaca St Metairie LA 70006-2913 |
| Practice Telephone | 5048876414 |
| Practice Fax Number | 5048875812 |
| Mailing Telephone | 5048876414 |
| Mailing Fax Number | 5048875812 |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2012-02-16 |
| Authorized Official Name | MR. DAVID HARGRAVE (ADMINISTRATOR) |
| Authorized Official Telephone | 5048876414 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 779 | LA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1521400 | 05 | |
| LA | ENTERAL | 4704660001 | 01 |
| Other Name | Type Code |
|---|---|
| Colonial Oaks Living Center | Doing Business As Name - Organization |
| Street Address |
4312 ITHACA ST |
| City | METAIRIE |
| State | LA |
| Zip Code | 70006-2913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497360432 | Colonial Oaks Care Center of Metairie, LLC | Skilled Nursing Facility | 4312 Ithaca St, Metairie, LA 70006-2913 | 2020-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437786365 | Christina Alder Humble | Behavior Technician | 4201 N 1-10 Service Road W., Metairie, LA 70006 | 2020-03-23 |
| 1285270959 | Brittanie Renee Tank | Behavior Technician | 4201 N 1-10 Service Rd, W, Metairie, LA 70006 | 2019-11-18 |
| 1447896105 | Jacob Dent Dds Dentists of Metairie A Professional Corporation | Dentist | 5201 Veterans Memorial Blvd., Suite A, Metairie, LA 70006 | 2019-11-18 |
| 1417504861 | Caryn Tesia Washington | Behavior Technician | 4201 N 1-10 Service Rd W., Metarie, LA 70006 | 2019-08-21 |
| 1568023356 | Brittany Nicole Davis | Behavioral Analyst | 4201 N-i 10 Service Rd, Metairie, LA 70006 | 2019-06-24 |
| 1295393650 | Beth Ann Martin | Behavior Technician | 4201 N. Service Road W, Metairie, LA 70006 | 2019-05-31 |
| 1942866561 | Manunique Johnson | Behavior Technician | 4201 N-1-10 Service Rd W., Metairie, LA 70006 | 2019-05-20 |
| 1972068419 | Stacey R Phipps | Behavior Technician | 4201 N 1-10 Service Rd. W., Metairie, LA 70006 | 2019-02-08 |
| 1740752799 | Na'triana Clark | Behavior Technician | 4210 N I-10 Service Rd, Metairie, LA 70006 | 2018-12-31 |
| 1861969131 | Lauren Hay Hughes | Behavior Technician | 4201 N 1-10 Service Rd. West, Metairie, LA 70006 | 2018-10-25 |
| Find all providers in zip 70006 | ||||
| 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 |
|---|---|---|---|---|
| 1578952727 | Triton Healthcare | Skilled Nursing Facility | 3212 38th St, Metairie, LA 70001-2802 | 2015-01-12 |
| 1013014141 | Metairie Operations, LLC | Skilled Nursing Facility | 6401 Riverside Dr, Metairie, LA 70003-3206 | 2006-09-20 |
| 1497360432 | Colonial Oaks Care Center of Metairie, LLC | Skilled Nursing Facility | 4312 Ithaca St, Metairie, LA 70006-2913 | 2020-09-15 |
| 1598267890 | University Healthcare System, L.c. | Skilled Nursing Facility | 4200 Houma Blvd, Metairie, LA 70006-2970 | 2018-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710464664 | Camelot of North Oaks LLC | Skilled Nursing Facility | 1560 Hwy 51, Ponchatoula, LA 70454-1560 | 2018-07-24 |
| 1730674557 | Louisiana Department of Health, Department of Health and Hospitals | Skilled Nursing Facility | 612 Henry Clay Ave., New Orleans, LA 70118 | 2018-06-25 |
| 1225534662 | Lhcg Xii, LLC | Skilled Nursing Facility | 2810 Ambassador Caffery Pkwy Fl 5, Lafayette, LA 70506-5906 | 2018-04-04 |
| 1518474238 | Colonial Manor Nursing and Rehabilitation Home Inc | Skilled Nursing Facility | 307 Foster Street, Rayville, LA 71269 | 2018-01-03 |
| 1962916726 | Mpd Operators Nazareth Hall LLC | Skilled Nursing Facility | 1905 N 7th St, West Monroe, LA 71291-4415 | 2017-11-30 |
| 1962934505 | Notre Dame Health System | Skilled Nursing Facility | 5600 General Degaulle Dr, New Orleans, LA 70131-7247 | 2017-04-02 |
| 1699225813 | Claiborne Operator Group LLC | Skilled Nursing Facility | 6942 Highway 79, Homer, LA 71040-2023 | 2016-10-12 |
| 1285180158 | Northshore Provider Group LLC | Skilled Nursing Facility | 48529 Red Fox Dr, Hammond, LA 70401-3715 | 2016-08-30 |
| 1518348259 | Ruston Scc LLC | Skilled Nursing Facility | 2401 N Service Rd E, Ruston, LA 71270-2342 | 2015-06-17 |
| 1861873770 | Booker Scc LLC | Skilled Nursing Facility | 7605 Line Ave, Shreveport, LA 71106-5162 | 2015-06-16 |
| 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.