Provider Demographics
NPI:1881985430
Name:AMIKIDS ACADIANA, INC,
Entity type:Organization
Organization Name:AMIKIDS ACADIANA, INC,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LAVERN
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-334-4838
Mailing Address - Street 1:611 CELESTINE LA TORTUE ROAD
Mailing Address - Street 2:
Mailing Address - City:BRANCH
Mailing Address - State:LA
Mailing Address - Zip Code:70516-0292
Mailing Address - Country:US
Mailing Address - Phone:337-334-4838
Mailing Address - Fax:337-334-3889
Practice Address - Street 1:611 CELESTINE LA TORTUE ROAD
Practice Address - Street 2:
Practice Address - City:BRANCH
Practice Address - State:LA
Practice Address - Zip Code:70516-0292
Practice Address - Country:US
Practice Address - Phone:337-334-4838
Practice Address - Fax:337-334-3889
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMIKIDS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-29
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty