NORTHWEST SUPPORTS AND SERVICES CENTER – NPI #1912125311
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.

NORTHWEST SUPPORTS AND SERVICES CENTER is a community based residential treatment facility located in BOSSIER CITY, LA. NPPES has assigned the NPI number 1912125311 to NORTHWEST SUPPORTS AND SERVICES CENTER on April 23, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The former legal business name for this organization is NORTHWEST LOUISIANA 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 Feb 27, 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 NORTHWEST SUPPORTS AND SERVICES CENTER below.

NPI Profile for
NORTHWEST SUPPORTS AND SERVICES CENTER

NPI Number
1912125311
Enumeration Date

(more than 19 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
NORTHWEST SUPPORTS AND SERVICES CENTER
Former Legal Business Name: NORTHWEST LOUISIANA DEVELOPMENTAL CENTER
Primary location
5401 SHED RD
BOSSIER CITY, LA 71111-5420
Phone: (318) 741-5230 Fax: (318) 741-5303
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DAVID COLVIN
ADMINISTRATOR
Phone: (318) 741-5230
Updated
Identifiers

Identifiers for NORTHWEST SUPPORTS AND SERVICES CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

See identifiers
DescriptionIssuerStateIdentifier
MEDICAIDLA1408182
MEDICAIDLA1712035
MEDICAIDLA1156752
MEDICAIDLA1156761
MEDICAIDLA1567230
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 PCA 8774

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.