ONE22 CRAFT ADVISORS CORPORATION (NPI# 1952935942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952935942 |
| Entity Type | Organization |
| Organization Name | ONE22 CRAFT ADVISORS CORPORATION |
| Practice Address |
626 E Jefferson Ave Bastrop LA 71220-4619 |
| Mailing Address |
2824 Gooseberry Dr Plano TX 75074-2044 |
| Practice Telephone | 2145669833 |
| Mailing Telephone | 2145669833 |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-02-27 |
| Authorized Official Name | MONTAVIAN MORROW SR. (CEO) |
| Authorized Official Telephone | 2145669833 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 276400000X | Rehabilitation, Substance Use Disorder Unit | Hospital Units | ||
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| N | 251B00000X | Case Management | Agencies | ||
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities | ||
| N | 385H00000X | Respite Care | Respite Care Facility | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | BH0011581 | 05 |
| Other Name | Type Code |
|---|---|
| Miracle Minds Managed Care | Doing Business As Name - Organization |
| Street Address |
626 E JEFFERSON AVE |
| City | BASTROP |
| State | LA |
| Zip Code | 71220-4619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952935983 | Broken Wings Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 2869 New Monroe Road, Bastrop, LA 71220 | 2020-02-28 |
| 1275002685 | Hulin Urgent Care Services, LLC | Clinic/Center | 2100 East Madison Avenue, Bastrop, LA 71220 | 2018-11-14 |
| 1023594975 | Shuntel Ramona Johnson | Counselor | 8891 Holley Farm Road, Bastrop, LA 71220 | 2018-07-13 |
| 1376050526 | Kevin Hubbard | Case Manager/Care Coordinator | 9409 Willow Dr, Bastrop, LA 71220 | 2018-01-09 |
| 1265957229 | Alma Holmes | Behavioral Analyst | 644 E. Jefferson Ave, Bastrop, LA 71220 | 2017-08-10 |
| 1427570886 | Jennifer Rochelle Glosson | Counselor | 410 S. Franklin St, Bastrop, LA 71220 | 2017-07-07 |
| 1386179307 | Total Divine Care LLC | Community/Behavioral Health | 1840 North Washington Street, Bastrop, LA 71220 | 2017-04-27 |
| 1538609524 | Tyrra Watkins | Counselor | 10599 Parkwood Dr, Bastrop, LA 71220 | 2017-02-24 |
| 1528502119 | Oatie Brooks | Counselor | 813 Mccreight Street, Bastrop, LA 71220 | 2016-12-15 |
| 1487197810 | Valencia Reese | Counselor | 10434 Boswell St, Bastrop, LA 71220 | 2016-12-03 |
| Find all providers in zip 71220 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962061267 | Crayton Counseling and Consulting LLC | Community/Behavioral Health | 2025 Antares Dr, Bastrop, LA 71220-3452 | 2019-06-10 |
| 1225526734 | People United of Louisiana LLC | Community/Behavioral Health | 406 Tisdale Dr, Bastrop, LA 71220-3747 | 2018-04-30 |
| 1386179307 | Total Divine Care LLC | Community/Behavioral Health | 1840 North Washington Street, Bastrop, LA 71220 | 2017-04-27 |
| 1376088690 | Bethea and Mcneal Behavioral Health Center LLC | Community/Behavioral Health | 651 E Madison Ave, Bastrop, LA 71220-3833 | 2016-12-21 |
| 1306225867 | Abounding Grace Community Services, Inc. | Community/Behavioral Health | 202 N Vine St, Bastrop, LA 71220-3749 | 2015-05-29 |
| 1336471796 | Family New Life Bastrop LLC | Community/Behavioral Health | 200 Mccreight St, Bastrop, LA 71220-3955 | 2010-02-09 |
| 1447396247 | Riversouth Rehabilitation Center, Inc. | Community/Behavioral Health | 410 S Franklin St, Bastrop, LA 71220-4533 | 2007-01-29 |
| 1346781150 | Better Day Advocates, LLC | Community/Behavioral Health | 644 E Jefferson Ave, Suite B, Bastrop, LA 71220-4619 | 2017-03-13 |
| 1558728147 | First Choice Counseling, LLC | Community/Behavioral Health | 644 E Jefferson Ave, Bastrop, LA 71220-4619 | 2016-01-27 |
| 1689030538 | Healthy Minds | Community/Behavioral Health | 209 W Jefferson Ave, Bastrop, LA 71220-4543 | 2016-01-07 |
| Find all providers in BASTROP | ||||
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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.