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Organization
PEDIATRIC GROUP OF ACADIANA LLC
Active
Organization
PEDIATRIC GROUP OF ACADIANA LLC
Active
Other names
St. Cecilia Family Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINETTE RABENALDT (CREDENTIALING COORDINATOR)
(337) 330-2576
Entity
Organization
Contact information
Practice address
2825 GRAND POINT HWY LOT 6, HENDERSON, LA 70517-6972
(337) 454-6238
(337) 408-1198
Mailing address
302 HACKER ST, NEW IBERIA, LA 70560-4508
(337) 330-2576
(337) 321-6295
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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