# PEDIATRIC GROUP OF ACADIANA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kids Clinic and Adult Wellness of Crowley
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679126510
- **Authorized official:** ANTOINETTE RABENALDT (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (337) 608-8988

## Contact information

- **Practice address:** 1307 CROWLEY RAYNE HWY STE C, CROWLEY, LA 70526-8210
- **Practice address phone:** (337) 250-4710
- **Mailing address:** 302 HACKER ST, NEW IBERIA, LA 70560-4508
- **Mailing address phone:** (337) 330-2576
- **Mailing address fax:** (337) 417-9909

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/19/2019
- **Last updated:** 08/29/2024