Provider Demographics
NPI:1932212586
Name:TARC
Entity Type:Organization
Organization Name:TARC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:BASS
Authorized Official - Last Name:SHAFFETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-549-0712
Mailing Address - Street 1:201 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-2628
Mailing Address - Country:US
Mailing Address - Phone:985-549-0712
Mailing Address - Fax:985-549-0743
Practice Address - Street 1:201 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-2628
Practice Address - Country:US
Practice Address - Phone:985-549-0712
Practice Address - Fax:985-549-0743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1435431Medicaid
LA1436674Medicaid
LA1436194Medicaid
LA1113425Medicaid