PROVENZA COMMUNITY HOME
NPI 1336279439
Intermediate Care Facility, Intellectual Disabilities in Zwolle, LA
NPI Status: Active since March 07, 2007
Contact Information
144 HAMLIN ST
ZWOLLE, LA
ZIP 71486
Phone: (318) 645-4191
Fax: (318) 256-0143
- Organization
- Intermediate Care Facility, Intellectual...
- CLIA Number: 19D0937302
- CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
- CLIA Exp. Date: 12-14-2025
About PROVENZA COMMUNITY HOME
This page provides the complete NPI Profile along with additional information for Provenza Community Home, a provider established in Zwolle, Louisiana operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1336279439 assigned on March 2007. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's other name is Provenza Community Home. The authorized official of this NPI record is Mr. Calvin Wayne Martinez (Exec Director)
- NPI
- 1336279439
- Provider Legal Name
- THE ARC OF SABINE INC
- Other Organization Name
- PROVENZA COMMUNITY HOME
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 144 HAMLIN ST ZWOLLE, LA 71486
- Location Phone
- (318) 645-4191
- Location Fax
- (318) 256-0143
- Mailing Address
- PO BOX 1150 MANY, LA 71449
- Mailing Phone
- (318) 256-2025
- Mailing Fax
- (318) 256-0143
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-07-2007
- Last Update Date
- 08-22-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Intermediate Care Facility, Intellectual Disabilities
- Taxonomy Code
- 315P00000X
- Type
- Nursing & Custodial Care Facilities
- Taxonomy Description
- An intermediate care facility providing services for individuals with intellectual disabilities.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1717720 | MEDICAID (05) | LA | |
| 19G469 | OTHER (01) | LA | DHH PROVIDER # |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 19D0937302
- Facility Type
- Intermediate Care Facility for Mentally Retarded
- Certificate Effective Date
- December 15, 2023
- Certificate Expiration Date
- December 14, 2025
- Laboratory Director
- ELLEN DOWNS, RN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Provenza Community Home to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 3 | 6 | 2 | 7 | 9 | 4 | 3 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 6 | 6 | 4 | 7 | 18 | 4 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 6 + 6 + 4 + 7 + 1 + 8 + 4 + 6 + 24 = 71 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 71 = 9 | 9 | ||||||||
The NPI number 1336279439 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336279439, enumerated in the NPI registry as an "organization" on March 07, 2007
The provider is located at 144 Hamlin St Zwolle, La 71486 and the phone number is (318) 645-4191
This medical organization specializes in Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 19D0937302 for a "intermediate care facility for mentally retarded" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on March 07, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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