Organization
MEDICAL ADVANTAGE CARE, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGEL PROVOST OLIVIER (EXECUTIVE DIRECTOR)
(337) 269-1629
Entity
Organization
Contact information
Practice address
216 8TH ST, LAFAYETTE, LA 70501-7163
(337) 269-1629
(337) 269-1628
Mailing address
216 8TH ST, LAFAYETTE, LA 70501-7163
(337) 269-1629
(337) 269-1628
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
11344
LA
251C00000X
Developmentally Disabled Services Day Training Agency
11345
LA
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
11347
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1142883
SIL PROVIDER NUMBER
LA
01
—
1171824
PCS PROVIDER NUMBER
LA
01
—
1188328
RESPITE PROVIDER NUMBER
LA
01
—
1188336
PCA PROVIDER NUMBER
LA
Enumeration date
11/01/2006
Last updated
08/22/2020
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