HERITAGE MANOR WEST LLC (NPI# 1770541922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770541922 |
| Entity Type | Organization |
| Organization Name | HERITAGE MANOR WEST LLC |
| Other Organization Name | HERITAGE MANOR WEST |
| Practice Address |
7060 Cotton Wood St Shreveport LA 71129-2722 |
| Practice Telephone | 3186311846 |
| Practice Fax Number | 3186362824 |
| Mailing Telephone | 3186311846 |
| Mailing Fax Number | 3186362824 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2015-06-22 |
| Authorized Official Name | MRS. TONI PARKINSON (AUTHORIZED REPRESENTATIVE) |
| Authorized Official Telephone | 60170914708 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 385H00000X | Respite Care | 2203782206 | LA | Respite Care Facility |
| Y | 314000000X | Skilled Nursing Facility | 2203782206 | LA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1521493 | 05 | |
| BLUE CROSS BLUE SHIELD | 30406 | 01 |
| Other Name | Type Code |
|---|---|
| Heritage Manor West | Doing Business As Name - Organization |
| Street Address |
7060 COTTON WOOD ST |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71129-2722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184241739 | D&d Transportation Agency LLC | Non-emergency Medical Transport (VAN) | 6171 Bert Kouns Industrial Loop, Apt D100, Shreveport, LA 71129 | 2020-06-30 |
| 1013407006 | Kimron Smith | Counselor | 7550 Pines Road Suite 1115, Shreveport, LA 71129 | 2018-05-15 |
| 1801383518 | Latarsha Parker | Counselor | 6009 Financial Plaza, Suite 105, Shreveport, LA 71129 | 2018-04-18 |
| 1003317652 | Demarkus Webb | Case Manager/Care Coordinator | 6117 Newton Abbott Dr, Shreveport, LA 71129 | 2018-02-27 |
| 1073024014 | Charnita Thomas | Case Manager/Care Coordinator | 5610 Buncombe Rd Apt 504, Shreveport, LA 71129 | 2017-10-17 |
| 1578073334 | Keyon Williams | Counselor | 7000 Red Fox Trail, Shreveport, Shreveport, LA 71129 | 2017-10-06 |
| 1689193765 | Beranna R Smith | Physical Therapy Assistant | 8186 Dance Dr., Shreveport, LA 71129 | 2017-09-11 |
| 1699204982 | Bac Foundation | Community/Behavioral Health | 8500 Pines Rd 19, Shrevepot, LA 71129 | 2017-06-08 |
| 1407381973 | Dominique Stevenson | Specialist | 6800 Rasberry Lane Apt.1901, Shreveport, LA 71129 | 2017-04-21 |
| 1538692496 | Dale Smith | Counselor | 5925 Dexter Pl, Shreveport, LA 71129 | 2017-04-07 |
| Find all providers in zip 71129 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861873770 | Booker Scc LLC | Skilled Nursing Facility | 7605 Line Ave, Shreveport, LA 71106-5162 | 2015-06-16 |
| 1073648853 | Booker T. Washington Guest Care Center, LLC | Skilled Nursing Facility | 7605 Line Ave., Shreveport, LA 71106-5162 | 2007-02-22 |
| 1275614497 | The Glen Retirement System | Skilled Nursing Facility | 1524 Glen Oak Pl, Shreveport, LA 71103-3816 | 2006-10-17 |
| 1417999780 | Shreveport Manor, LLC | Skilled Nursing Facility | 3302 Mansfield Rd, Shreveport, LA 71103-4106 | 2006-06-12 |
| 1609818046 | The Guest Care At Spring Lake, LLC | Skilled Nursing Facility | 8622 Line Ave, Shreveport, LA 71106-6108 | 2006-06-11 |
| 1073555652 | The Guest House LLC | Skilled Nursing Facility | 9225 Normandie Dr, Shreveport, LA 71118-3249 | 2006-06-11 |
| 1235179086 | Bradford Guest Care, LLC | Skilled Nursing Facility | 3050 Baird Rd, Shreveport, LA 71118-3818 | 2006-06-08 |
| 1619917432 | Multi-faith Retirement Services | Skilled Nursing Facility | 600 E Flournoy Lucas Rd, Shreveport, LA 71115-3855 | 2006-06-08 |
| 1508805037 | Heritage Manor Stratmore Nursing & Rehabilitation Center LLC | Skilled Nursing Facility | 530 Stratmore Dr, Shreveport, LA 71115-3020 | 2006-06-06 |
| 1144267451 | Willis Knighton Medical Center, Inc. | Skilled Nursing Facility | 2550 Kings Hwy, Shreveport, LA 71103-3922 | 2006-06-02 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71129 |
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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.