Provider Demographics
NPI:1700214186
Name:ACADIANA AREA HUMAN SERVICES DISTRICT
Entity Type:Organization
Organization Name:ACADIANA AREA HUMAN SERVICES DISTRICT
Other - Org Name:CROWLEY BEHAVIORAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADM. PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-262-1329
Mailing Address - Street 1:1822 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-4720
Mailing Address - Country:US
Mailing Address - Phone:337-788-7511
Mailing Address - Fax:337-788-7588
Practice Address - Street 1:1822 W 2ND ST
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-4720
Practice Address - Country:US
Practice Address - Phone:337-788-7511
Practice Address - Fax:337-788-7588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA482101YA0400X
LA117261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1710121Medicaid
LA5DG72OtherPTAN