Provider Demographics
NPI:1396219101
Name:ARC OF ACADIANA, INC
Entity Type:Organization
Organization Name:ARC OF ACADIANA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR RESDIENTIAL SERVICES
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:337-367-8301
Practice Address - Street 1:1601 EAST B NORTH ST
Practice Address - Street 2:
Practice Address - City:RAYNE
Practice Address - State:LA
Practice Address - Zip Code:70578
Practice Address - Country:US
Practice Address - Phone:337-367-6813
Practice Address - Fax:337-367-8301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARC OF ACADIANA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
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
LA1718106Medicaid
LA2155059Medicaid
LA1715131Medicaid
LA1724971Medicaid
LA1718637Medicaid
LA2313061Medicaid
LA1098914Medicaid
LA1716391Medicaid