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THE BLAKE AT BOSSIER CITY OPERATING CO LLC
NPI 1659923100
Assisted Living Facility in Bossier City, LA

Active since July 15, 2019CLIA 19D2145583 · Waiver
2000 BLAKE BLVD, BOSSIER CITY, LA 71111(318) 752-6611(318) 415-6411 Get Directions Write a Review

NPPES record last updated: July 15, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About The Blake At Bossier City Operating Co Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE BLAKE AT BOSSIER CITY OPERATING CO LLC (NPI 1659923100) is a healthcare organization registered as an assisted living facility in Bossier City, Louisiana and active in the NPI registry since July 2019. The organization holds a CLIA Waiver certificate valid through March 11, 2028 and lists Renee Matheny, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1659923100
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameTHE BLAKE AT BOSSIER CITY OPERATING CO LLC
Location Address2000 BLAKE BLVDBossier City, LA 71111-2232
Mailing Address2000 Blake BlvdBossier City, LA 71111-2232 · (318) 752-6611 · Fax (318) 415-6411
Phone(318) 752-6611
Fax(318) 415-6411
Organization SubpartNo
Authorized OfficialRenee MathenyExecutive Director · (318) 752-6611
Enumeration DateJuly 15, 2019
✔ NPI 1659923100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
2000 BLAKE BLVD, Bossier City, LA 71111
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Other Names 1

Other NameThe Blake At Bossier City

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 19D2145583

The Blake At Bossier City Operating Company LLC · Bossier City, LA
Active · expires Mar 11, 2028
CLIA Number19D2145583
Laboratory TypeAssisted Living Facility
Certificate Effective DateMarch 12, 2026
Certificate Expiration DateMarch 11, 2028
Laboratory DirectorRenee Matheny
Laboratory Phone(318) 752-6611
Laboratory LocationThe Blake At Bossier City Operating Company LLC2000 Blake Boulevard, Bossier City, LA 71111
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LOUISIANA PHYSICAL THERAPY SERVICES OF BOSSIER CITY, LLC
Physical Therapist
2000 BLAKE BLVD
BOSSIER CITY, LA 71111
Bossier Parish (337) 233-1307
DR. BRADLEY KENT MOORE PT
Physical Therapist
2000 BLAKE BLVD
BOSSIER CITY, LA 71111
Bossier Parish (318) 383-6751
LAURA CARAWAY DPT
Physical Therapist
2000 BLAKE BLVD
BOSSIER CITY, LA 71111
Bossier Parish (318) 752-6611

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Blake At Bossier City Operating Co LLC's NPI number?

The NPI number for The Blake At Bossier City Operating Co LLC is 1659923100. It was assigned to this organization in the NPPES registry on July 15, 2019. The provider is also known as The Blake at Bossier City.

Where is The Blake At Bossier City Operating Co LLC located?

The Blake At Bossier City Operating Co LLC is located at 2000 Blake Blvd, Bossier City, LA 71111. The listed phone number is (318) 752-6611.

What is The Blake At Bossier City Operating Co LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does The Blake At Bossier City Operating Co LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 19D2145583) is associated with this NPI, valid through March 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for The Blake At Bossier City Operating Co LLC was last updated on July 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.