CERTICARE, INC.


Address: 3018 Old Minden Rd, 1110, Bossier City, LA 71112-2446
Phone: 3187424510

CERTICARE, INC. (NPI# 1457537169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457537169
Entity Type Organization
Organization Name CERTICARE, INC.
Practice Address 3018 Old Minden Rd
1110
Bossier City
LA 71112-2446
Mailing Address 107 West Alabama Ave
Ruston
LA 71270
Practice Telephone 3187424510
Practice Fax Number 3187424096
Mailing Telephone 3182551077
Mailing Fax Number 3182548250
Enumeration Date 2008-01-11
Last Update Date 2008-02-06
Authorized Official Name MR. MICHAEL D DOUGLAS SR. (PRESIDENT/CEO)
Authorized Official Telephone 3182551077
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
LA 1784613 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1962692541 Certicare, Inc. Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 413 S Farmerville St, Ruston, LA 71270-4654 2007-07-30

Office Location

Street Address 3018 OLD MINDEN RD
1110
City BOSSIER CITY
State LA
Zip Code 71112-2446

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619946001 Lionel Guillaume Specialist 3018 Old Minden Rd, Suite 1212, Bossier City, LA 71112-2495 2006-03-16
1124540059 Jazmine Cooper Case Manager/Care Coordinator 3018 Old Minden Rd, Bossier City, LA 71112 2017-07-12
1356880397 Gary Dupree Jr. Counselor 3018 Old Minden Rd, Bossier City, LA 71112-2476 2017-02-22
1407395049 Brandy Brown Case Manager/Care Coordinator 3018 Old Minden Rd, Bossier City, LA 71112-2476 2017-02-15
1659813178 Elise Gardner Counselor 3018 Old Minden Rd, Bossier City, LA 71112-2476 2016-11-15
1962952507 Joyce Wheeler Counselor 3018 Old Minden Rd, Bossier City, LA 71112-2476 2016-10-06
1467808196 Ruthie Adams Counselor 3018 Old Minden Rd, Bossier City, LA 71112-2476 2016-05-12
1699138370 Sarah Barfield Counselor 3018 Old Minden Rd, Bossier City, LA 71112-2476 2016-03-31
1750756482 Audria Lynette Musgrove Counselor 3018 Old Minden Rd, Bossier City, LA 71112-2476 2015-12-07
1982079026 Tacita Long Counselor 3018 Old Minden Rd, Bossier City, LA 71112-2476 2015-12-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1154810349 Brittany Ariel Boone Case Manager/Care Coordinator 2323 Old Minden Rd Ste 500, Bossier City, LA 71112 2018-05-03
1396254520 Abartllc Non-emergency Medical Transport (VAN) 400 John Wesley Blvd Apt 195, Bossier City, LA 71112 2017-09-19
1124547708 Kendra Webster Counselor 3018 Old Minden Rd. Ste 1200, Bossier City, LA 71112 2017-09-14
1851818009 Latonya Renee' Williams Case Manager/Care Coordinator 5383 Bluebell Dr, Bossier City, LA 71112 2017-08-28
1578084299 Christian Sledge Counselor 1011 Princeton Ave, Bossier City, LA 71112 2017-07-03
1861925240 Kyanna Williams Cosby Counselor 4009 Parkway Dr, Bossier City, LA 71112 2017-04-04
1962858191 Jemeel Latrice Webb Case Manager/Care Coordinator 1787 Southview Drive, Bossier City, LA 71112 2016-05-06
1174986244 Jaquitua Russell Case Manager/Care Coordinator 5005 Longstreet Pl Unit 1, Bossier City, LA 71112 2016-04-05
1528423175 Deanna Lorraine Edwards Contractor 4007 Parkway Dr, Bossier City, LA 71112 2015-12-28
1700258605 Derrick Thomas Counselor 2601 Hoyer St, Bossier City, LA 71112 2015-10-30
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Taxonomy Information

Taxonomy Code 320600000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689715179 Northwest Supports and Services Center Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 5401 Shed Rd, Bossier City, LA 71111-5420 2007-02-09
1467630475 Certicare,inc. Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 3018 Old Minden Rd, Suite 1110, Bossier City, LA 71112-2446 2008-02-01
1730205212 Louise S Davis Residential Facilities, LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2901 Douglas Dr, Bossier City, LA 71111-5807 2007-03-22
1316063035 Louise S Davis Residential Facilities, LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2901 Douglas Dr, Bossier City, LA 71111-5807 2007-03-22
1932225562 Louise S Davis Residential Facilities, LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2901 Douglas Dr, Bossier City, LA 71111-5807 2007-03-22
1790801264 Louise S Davis Residential Facilities, LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2901 Douglas Dr, Bossier City, LA 71111-5807 2007-03-22
1558487025 Louise S Davis Residential Facilities, LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2901 Douglas Dr, Bossier City, LA 71111-5807 2007-03-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1265041446 Serene Living LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1567 Shirley Dr, New Orleans, LA 70114-2911 2020-07-23
1609495324 180 Family Services Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 9418 Brookline Ave Ste B, Baton Rouge, LA 70809-1428 2020-04-13
1902442395 Arc of Acadiana, Inc Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 106 Jackie Street, Rayne, LA 70578-7056 2019-11-21
1033766126 Believe Therapeutic Group Home Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 8566 Bayou Run Dr, New Roads, LA 70760-2454 2019-08-22
1063065217 House of Nola Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 10073 Pleasant Dr, Bastrop, LA 71220-6347 2019-07-17
1396219101 Arc of Acadiana, Inc Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1601 East B North St, Rayne, LA 70578 2019-01-15
1316393531 Evergreen Presbyterian Ministries, Inc. Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1538 Camellia Dr, Hammond, LA 70403-6228 2016-05-06
1164801726 Grover Therapy LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 218 Brumley Ln, Duson, LA 70529-4022 2015-05-28
1124418348 Evergree Presbyterian Ministries, Inc. Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 43488 Klein Road, Hammond, LA 70403 2015-01-26
1962892331 Evergreen Presbyterian Ministries,inc. Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 955 Live Oak Ct, Ponchatoula, LA 70454-4869 2015-01-23
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Competitor

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City BOSSIER CITY
Zip Code 71112

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Dataset Information

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.

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