ANGELINA DRIVE COMMUNITY HOME – NPI #1215172549
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

ANGELINA DRIVE COMMUNITY HOME is a community based residential treatment facility located in LEESVILLE, LA. NPPES has assigned the NPI number 1215172549 to ANGELINA DRIVE COMMUNITY HOME on December 16, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ANGELINA DRIVE COMMUNITY HOME” is a dba name, the actual legal business name for this organization is PINECREST DEVELOPMENTAL CENTER. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was previously updated about 17 years ago on Mar 25, 2009. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ANGELINA DRIVE COMMUNITY HOME below.

NPI Profile for
PINECREST DEVELOPMENTAL CENTER

NPI Number
1215172549
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PINECREST DEVELOPMENTAL CENTER
Doing Business As (dba): ANGELINA DRIVE COMMUNITY HOME
Primary location
107 ANGELINA DRIVE
LEESVILLE, LA 71446
Phone: (337) 239-2687 Fax:
Mailing address
PO BOX 131
LEESVILLE, LA 71496-0131
Phone: (337) 239-2687 Fax:
Organization Subpart
No
Authorized Official
RONALD WILLIAMS
ADMINISTRATOR
Phone: (337) 239-2687
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)		 LA 1036

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.