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NPI Code Detail

MEDICARE: ARC OF SAFETY OUTREACH COMMUNITY DEVELOPMENT, INC.

MEDICARE: ARC OF SAFETY OUTREACH COMMUNITY DEVELOPMENT, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyLA

General Provider Information

NPI Number : 1497148068
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARC OF SAFETY OUTREACH COMMUNITY DEVELOPMENT, INC.
Provider Business Mailing Address
First Line : 3973 CHOCTAW DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-6722
Country : US
Telephone Number : 225-361-0507
Fax Number :
Provider Business Practice Location Address
First Line : 3973 CHOCTAW DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-6722
Country : US
Telephone Number : 225-361-0507
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS
Name : DR. CARL M. WILLIAMS
Credential :
Telephone Number : 225-394-9271
Provider Enumeration Date : 03/06/2015
Last Update Date : 07/21/2022

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