Provider Demographics
NPI:1629122197
Name:ACADIANA PERSONAL CARE SERVICES
Entity Type:Organization
Organization Name:ACADIANA PERSONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANELL
Authorized Official - Middle Name:E
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-291-2897
Mailing Address - Street 1:515 S COLLEGE RD STE 125
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3391
Mailing Address - Country:US
Mailing Address - Phone:337-291-2897
Mailing Address - Fax:337-291-6066
Practice Address - Street 1:515 S COLLEGE RD STE 125
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3391
Practice Address - Country:US
Practice Address - Phone:337-291-2897
Practice Address - Fax:337-291-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11189251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1173797Medicaid