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Organization
ARC OF ACADIANA, INC
Active
Organization
ARC OF ACADIANA, INC
Active
Other names
Jackie Street Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI LEE BOOK STUTES (RESIDENTIAL DIRECTOR)
(337) 367-6813
Entity
Organization
Contact information
Practice address
106 JACKIE STREET, RAYNE, LA 70578-7056
(337) 367-6813
Mailing address
6400 HIGHWAY 90 W, NEW IBERIA, LA 70560-7836
(337) 367-6813
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1098914
—
LA
05
—
1715131
—
LA
05
—
1716391
—
LA
05
—
1718106
—
LA
05
—
1718637
—
LA
05
—
1724971
—
LA
05
—
2155059
—
LA
05
—
2313061
—
LA
Enumeration date
11/21/2019
Last updated
11/21/2019
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