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IVY GROUP HOME
NPI 1720104466
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Shreveport, LA

Active since March 22, 2007
1411 CLAIBORNE AVE, SHREVEPORT, LA 71103(337) 439-6600(337) 439-6647 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ivy Group Home NPPES

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

IVY GROUP HOME (NPI 1720104466) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Shreveport, Louisiana and active in the NPI registry since March 2007. The organization lists Kendall A Broussard, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1720104466
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameLOUISE S DAVIS RESIDENTIAL FACILITIES, LLC
Location Address1411 CLAIBORNE AVEShreveport, LA 71103-4203
Mailing Address1 Lakeshore Dr, Suite 1900Lake Charles, LA 70629-0100 · (337) 439-6600 · Fax (337) 439-6647
Phone(337) 439-6600
Fax(337) 439-6647
Organization SubpartNo
Authorized OfficialKendall A BroussardManaging Member · (337) 439-6600
Enumeration DateMarch 22, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1720104466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
License✔ Licensed in LA · 970
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
1411 CLAIBORNE AVE, Shreveport, LA 71103
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Other Names 1

Doing Business AsIvy Group Home

Other Identifiers 1

Medicaid1710971LA

Other Providers at the Same Location NPPES 2

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

LOUISE S DAVIS RESIDENTIAL FACILITIES, LLC
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1411 CLAIBORNE AVE
SHREVEPORT, LA 71103
Caddo Parish (337) 439-6600
MAGNOLIA MANOR NURSING & REHAB CNTR LLC
Skilled Nursing Facility
1411 CLAIBORNE AVE
SHREVEPORT, LA 71103
Caddo Parish (318) 868-4421

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 Louise S Davis Residential Facilities, LLC's NPI number?

The NPI number for Louise S Davis Residential Facilities, LLC is 1720104466. It was assigned to this organization in the NPPES registry on March 22, 2007. The provider is doing business as Ivy Group Home.

Where is Louise S Davis Residential Facilities, LLC located?

Louise S Davis Residential Facilities, LLC is located at 1411 Claiborne Ave, Shreveport, LA 71103. The listed phone number is (337) 439-6600.

What is Louise S Davis Residential Facilities, LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Louise S Davis Residential Facilities, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.