Provider Demographics
NPI:1528388261
Name:REGIONAL PCA SERVICES - ACADIANA, LLC
Entity Type:Organization
Organization Name:REGIONAL PCA SERVICES - ACADIANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-928-8989
Mailing Address - Street 1:8352 BLUEBONNET BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2825
Mailing Address - Country:US
Mailing Address - Phone:225-928-8989
Mailing Address - Fax:225-928-8990
Practice Address - Street 1:2448 JOHNSTON ST
Practice Address - Street 2:SUITE A
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2756
Practice Address - Country:US
Practice Address - Phone:337-704-0188
Practice Address - Fax:337-704-0169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15383253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care