Organization
ARC OF ACADIANA, INC
Active
Other names
Arc of Acadiana Northwest
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLOTTE CORMIER JACKSON (DIRECTOR OF RESIDENTIAL SERVICES)
(337) 367-6813
Entity
Organization
Contact information
Practice address
5401 SHED RD, BOSSIER CITY, LA 71111-5420
(318) 742-6220
(318) 741-5297
Mailing address
5401 SHED RD, BOSSIER CITY, LA 71111-5420
(318) 742-6220
(318) 741-5297
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2853
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1098914
—
LA
05
—
1715131
—
LA
05
—
1716391
—
LA
05
—
1718637
—
LA
05
—
2155059
—
LA
Enumeration date
09/18/2012
Last updated
09/18/2012
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