Provider Demographics
NPI:1376540153
Name:ACADIA-ST. LANDRY HOSPITAL SERVICE DISTRICT
Entity Type:Organization
Organization Name:ACADIA-ST. LANDRY HOSPITAL SERVICE DISTRICT
Other - Org Name:ACADIA-ST. LANDRY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEJUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-684-4277
Mailing Address - Street 1:810 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:CHURCH POINT
Mailing Address - State:LA
Mailing Address - Zip Code:70525-4402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CHURCH POINT
Practice Address - State:LA
Practice Address - Zip Code:70525-4402
Practice Address - Country:US
Practice Address - Phone:337-684-5435
Practice Address - Fax:337-684-5449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA106282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA60686OtherACUTE
LA1734314Medicaid
LA1416002Medicaid
LA43906OtherACUTE
LA60686OtherACUTE