Organization
ACADIANA REGION SUPPORTS AND SERVICES CENTER
Active
Other names
MCMILLIAN AVENUE COMMUNITY HOME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL K MCDANIEL (MR DD REGIONAL ADMINISTRATOR)
(337) 824-6250
Entity
Organization
Contact information
Practice address
530 MCMILLIAN AVE, IOTA, LA 70543
(337) 779-2121
(337) 821-9306
Mailing address
PO BOX 218, 224 GREMILLION CIRCLE, IOTA, LA 70543-0218
(337) 824-6250
(337) 821-9306
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
10658
LA
Other
Enumeration date
11/02/2009
Last updated
11/02/2009
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