Provider Demographics
NPI:1275243495
Name:NATCHITOCHES ASSOCIATION FOR RETARDED CITIZENS, INC.
Entity Type:Organization
Organization Name:NATCHITOCHES ASSOCIATION FOR RETARDED CITIZENS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-352-5176
Mailing Address - Street 1:127 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-3101
Mailing Address - Country:US
Mailing Address - Phone:318-352-5176
Mailing Address - Fax:318-352-0887
Practice Address - Street 1:127 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-3101
Practice Address - Country:US
Practice Address - Phone:318-352-5176
Practice Address - Fax:318-352-0887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4506051Medicaid