Provider Demographics
NPI:1588204150
Name:ACTIVITIES OF DAILY LIVING BEHAVIORAL HEALTH SERVICES INC
Entity Type:Organization
Organization Name:ACTIVITIES OF DAILY LIVING BEHAVIORAL HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-414-6126
Mailing Address - Street 1:402 RICHARD STREET
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517
Mailing Address - Country:US
Mailing Address - Phone:337-278-3349
Mailing Address - Fax:
Practice Address - Street 1:402 RICHARD STREET
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-7051
Practice Address - Country:US
Practice Address - Phone:337-278-3349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACTIVITIES OF DAILY LIVING SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health