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
—
—
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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