Provider Demographics
NPI:1629014642
Name:NEUROPSYCHIATRIC CLINIC OF ACADIANA LLC
Entity Type:Organization
Organization Name:NEUROPSYCHIATRIC CLINIC OF ACADIANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HULIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-232-9113
Mailing Address - Street 1:1105 S COLLEGE RD
Mailing Address - Street 2:STE A
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503
Mailing Address - Country:US
Mailing Address - Phone:337-232-9113
Mailing Address - Fax:337-232-0022
Practice Address - Street 1:1105 S COLLEGE RD
Practice Address - Street 2:STE A
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503
Practice Address - Country:US
Practice Address - Phone:337-232-9113
Practice Address - Fax:337-232-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1940780Medicaid
SCG20Medicare ID - Type Unspecified