Provider Demographics
NPI:1134459456
Name:ACADIANA SUPPORT SERVICES
Entity Type:Organization
Organization Name:ACADIANA SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:SILAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:337-984-8875
Mailing Address - Street 1:318 HAYDITE AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70507-6308
Mailing Address - Country:US
Mailing Address - Phone:337-984-8875
Mailing Address - Fax:337-984-8879
Practice Address - Street 1:318A GUILBEAU RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6914
Practice Address - Country:US
Practice Address - Phone:337-984-8875
Practice Address - Fax:337-984-8879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15087253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care