Provider Demographics
NPI:1902442395
Name:ARC OF ACADIANA, INC
Entity Type:Organization
Organization Name:ARC OF ACADIANA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENTIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:LEE BOOK
Authorized Official - Last Name:STUTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-367-6813
Mailing Address - Street 1:6400 HIGHWAY 90 W
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-7836
Mailing Address - Country:US
Mailing Address - Phone:337-367-6813
Mailing Address - Fax:
Practice Address - Street 1:106 JACKIE STREET
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578-7056
Practice Address - Country:US
Practice Address - Phone:337-367-6813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1715131Medicaid
LA1718106Medicaid
LA1718637Medicaid
LA2313061Medicaid
LA1716391Medicaid
LA1098914Medicaid
LA2155059Medicaid
LA1724971Medicaid