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
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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