COMMUNITY BRIDGES WEST, INC. (NPI# 1134255912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134255912 |
| Entity Type | Organization |
| Organization Name | COMMUNITY BRIDGES WEST, INC. |
| Other Organization Name | MORIAH HOME |
| Practice Address |
1215 S Maple St Ruston LA 71270-5127 |
| Mailing Address |
Po Box 715 Ruston LA 71273-0715 |
| Practice Telephone | 3182559137 |
| Practice Fax Number | 3182558233 |
| Mailing Telephone | 3182559137 |
| Mailing Fax Number | 3182558233 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MIKE L. REYNOLDS (CEO) |
| Authorized Official Telephone | 3182559137 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 935 | LA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1711250 | 05 |
| Other Name | Type Code |
|---|---|
| Moriah Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386770162 | Community Bridges West, Inc. | Intermediate Care Facility, Mentally Retarded | 115 Sherwood Dr, Benton, LA 71006-9701 | 2007-02-26 |
| 1255467031 | Community Bridges West, Inc. | Intermediate Care Facility, Mentally Retarded | 2515 Brownlee Rd, Bossier City, LA 71111-2011 | 2007-02-26 |
| 1467692137 | Community Bridges West, Inc. | In Home Supportive Care | 1201 Atkins Rd, Ruston, LA 71270-8717 | 2009-02-20 |
| 1326288002 | Community Bridges West, Inc. | Case Management | 1201 Atkins Rd, Ruston, LA 71270-8717 | 2009-02-20 |
| Street Address |
1215 S MAPLE ST |
| City | RUSTON |
| State | LA |
| Zip Code | 71270-5127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821315 | Olivia Mason | Marriage & Family Therapist | 413 North Homer Street, Ruston, LA 71270 | 2020-11-04 |
| 1972146132 | Razz Addiction and Recovery, LLC | Family Medicine | 570 Heard Rd, Ruston, LA 71270 | 2019-10-21 |
| 1518435999 | Tenia Holloway | Case Manager/Care Coordinator | 612 Henderson St., F12, Ruston, LA 71270 | 2018-11-05 |
| 1245708718 | A Plus Medical of Ruston LLC | Family Medicine | 612 S Farmerville Street, Ruston, LA 71270 | 2018-11-02 |
| 1255808085 | Amanda M Clark | Specialist/Technologist | 2301 Timberline Ct Apt F105, Ruston, LA 71270 | 2018-10-30 |
| 1912473752 | Lincoln Nova Vital Recovery | Counselor | 4396 Hwy, 80, 617 South Trention, Ruston, LA 71270 | 2018-10-19 |
| 1861975237 | Wymeka Andrea Breaux | Case Manager/Care Coordinator | 705 Martin Luther King Dr., Ruston, LA 71270 | 2018-09-12 |
| 1790292001 | Louquyhanta Foster | Case Manager/Care Coordinator | 593 Belton Rd, Ruston, LA 71270 | 2018-01-08 |
| 1609391010 | Chemia Herron | Counselor | 775 S Bonner, Ruston, LA 71270 | 2017-08-07 |
| 1477083517 | Arnesha Beard | Counselor | 775 South Bonner, Ruston, LA 71270 | 2017-06-12 |
| Find all providers in zip 71270 | ||||
| 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 |
|---|---|---|---|---|
| 1477689867 | Community Bridges South, Inc. | Intermediate Care Facility, Mentally Retarded | 150 Trace Dr, Ruston, LA 71270-3449 | 2007-02-27 |
| 1588790976 | Community Bridges South, Inc. | Intermediate Care Facility, Mentally Retarded | 225 S Maple St, Ruston, LA 71270-4120 | 2007-02-27 |
| 1386770774 | Community Bridges South, Inc. | Intermediate Care Facility, Mentally Retarded | 155 Woodshire Ln, Ruston, LA 71270-3292 | 2007-02-27 |
| 1679609069 | Community Bridges South, Inc. | Intermediate Care Facility, Mentally Retarded | 2600 S Vienna St, Ruston, LA 71270-9026 | 2007-02-27 |
| 1396871786 | Community Bridges South, Inc. | Intermediate Care Facility, Mentally Retarded | 2909 S Vienna St, Ruston, LA 71270-9029 | 2007-02-27 |
| 1073649463 | Community Bridges South, Inc. | Intermediate Care Facility, Mentally Retarded | 1406 Campbell Street, Ruston, LA 71270 | 2007-02-27 |
| 1770619876 | Community Bridges South | Intermediate Care Facility, Mentally Retarded | 1400 Benton St, Ruston, LA 71270-5404 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174136527 | St. Mary's Residential Training School | Intermediate Care Facility, Mentally Retarded | 1901 Huie Dellmon Ave, Boyce, LA 71409-9329 | 2020-08-26 |
| 1174136535 | St. Mary's Residential Training School | Intermediate Care Facility, Mentally Retarded | 1903 Huie Dellmon Ave, Boyce, LA 71409-9329 | 2020-08-26 |
| 1427613371 | Lisa Williams | Intermediate Care Facility, Mentally Retarded | 1202 St. Maurice Ave, New Orleans, LA 70117-7011 | 2019-05-07 |
| 1700324084 | Magnolia Community Services, Inc | Intermediate Care Facility, Mentally Retarded | 821 Jefferson Heights Ave., Jefferson, LA 70121 | 2017-02-07 |
| 1801260468 | Magnolia Community Services, Inc | Intermediate Care Facility, Mentally Retarded | 143 Central Ave, Jefferson, LA 70121-3401 | 2015-11-19 |
| 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 |
| 1073904389 | Normal Life of Louisiana, Inc. | Intermediate Care Facility, Mentally Retarded | 15460 Tracey Ln, Independence, LA 70443-2470 | 2015-02-09 |
| 1306276639 | The Arc of Sabine Inc | Intermediate Care Facility, Mentally Retarded | 200 Dockens Dr, Many, LA 71449-3852 | 2013-11-22 |
| 1326304445 | Cdf Healthcare of La, LLC | Intermediate Care Facility, Mentally Retarded | 596 Midway Church Lane, Delhi, LA 71232 | 2012-04-03 |
| 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.