RESTORATION CRISIS CENTER THERAPEUTIC HOME (NPI# 1558857888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558857888 |
Entity Type | Organization |
Organization Name | RESTORATION CRISIS CENTER THERAPEUTIC HOME |
Other Organization Name | RESTORATION CRISIS CENTER THERAPEUTIC HOME |
Practice Address |
6808 Jefferson Paige Rd Shreveport LA 71119-3302 |
Practice Telephone | 3183471963 |
Mailing Telephone | 3185259000 |
Mailing Fax Number | 3185259007 |
Enumeration Date | 2018-07-10 |
Last Update Date | 2018-07-10 |
Authorized Official Name | LISA SWEENEY (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 3185259000 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 16331 | LA | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
Restoration Crisis Center Therapeutic Home | Doing Business As Name - Organization |
Street Address |
6808 JEFFERSON PAIGE RD |
City | SHREVEPORT |
State | LA |
Zip Code | 71119-3302 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528461480 | Antwan Raheem Butler | Social Worker | 6808 Jefferson Paige Rd, Shreveport, LA 71119-3302 | 2014-10-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912549825 | Andrea Lekesha Brown | Case Manager/Care Coordinator | 3518 Milky Way, Shreveport, LA 71119 | 2019-10-11 |
1003380213 | Eiyana Middleton | Case Manager/Care Coordinator | 5720 S Lakeshore Dr Apt 1711, Shreveport, LA 71119 | 2019-01-22 |
1508341264 | Cassandra Marshall | Case Manager/Care Coordinator | 5905 Candlewood, Shreveport, LA 71119 | 2018-09-28 |
1184125734 | Shunda Huff | Case Manager/Care Coordinator | 5636 S Lakeshore Dr Apt 632, Shreveport, LA 71119 | 2018-02-27 |
1093239162 | Nicole Devona Wahsington | Counselor | 2811 Metal Street, Shreveport, LA 71119 | 2017-07-31 |
1396266318 | Cynthia M Thomas | Driver | 6407 Santa Monica Blvd., Shreveport, LA 71119 | 2017-06-29 |
1154861771 | Allan Thomas | Case Manager/Care Coordinator | 3205 Linda St, Shreveport, LA 71119 | 2017-03-01 |
1366984312 | Demetria Carter | Counselor | 4164 Mcmichael Ave, Shreveport, LA 71119 | 2016-11-08 |
1033667712 | Mary Craig | Case Manager/Care Coordinator | 6215 Border Ln, Shreveport, LA 71119 | 2016-09-12 |
1538615067 | Jesse Fallis | Counselor | New Day Recovery/ Shreveport, 6240 Greenwood Rd, Shreveport, LA 71119 | 2016-08-25 |
Find all providers in zip 71119 |
Taxonomy Code | 322D00000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Emotionally Disturbed Children |
A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912516188 | Serene Living LLC | Residential Treatment Facility, Emotionally Disturbed Children | 4032 Erato St, New Orleans, LA 70125-1918 | 2020-07-23 |
1306481445 | Upgrade Group Home LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3719 Katherine Ave, 3719 Katherine Ave, Baton Rouge, LA 70805 | 2019-11-13 |
1144862707 | Care Life Inc | Residential Treatment Facility, Emotionally Disturbed Children | 136 Barton Pl, Breaux Bridge, LA 70517-5130 | 2019-10-15 |
1912476482 | Gbc Hope | Residential Treatment Facility, Emotionally Disturbed Children | 311 South 1st Street, Monroe, LA 71201 | 2018-11-14 |
1528564184 | House of Judah International, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4104 Spurgeon Dr, Monroe, LA 71203-4415 | 2018-04-03 |
1104344258 | Hopeful Hearts Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1104 W. Saint Peter Street, New Iberia, LA 70560-7056 | 2017-09-08 |
1073971297 | Core Agency Group | Residential Treatment Facility, Emotionally Disturbed Children | 865 Williams Colony Rd, Downsville, LA 71234-5905 | 2016-02-02 |
1891049714 | Lighthouse Ministries, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 180 Lighthouse Ln, Reeves, LA 70658-5941 | 2012-10-30 |
1447503016 | Raintree Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1219 8th St, New Orleans, LA 70115-3332 | 2012-10-19 |
1124376165 | Louis Infant Crisis Center | Residential Treatment Facility, Emotionally Disturbed Children | 221 El Paso Dr, Houma, LA 70360-7309 | 2012-08-23 |
Find all providers with the same taxonomy |
City | SHREVEPORT |
Zip Code | 71119 |
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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.