Organization
ACADIANA COMMUNITY BASED SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY LARRY MANKIN (PRESIDENT)
(337) 261-1571
Entity
Organization
Contact information
Practice address
412 W UNIVERSITY AVE, SUITE 105, LAFAYETTE, LA 70506-3671
(337) 261-1571
(337) 261-1067
Mailing address
412 W UNIVERSITY AVE, SUITE 105, LAFAYETTE, LA 70506-3671
(337) 261-1571
(337) 261-1067
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
PCA 8202
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1691852
—
LA
Enumeration date
03/09/2006
Last updated
08/22/2020
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