Healthcare Provider Details

I. General information

NPI: 1902316763
Provider Name (Legal Business Name): HOSPICE OF ACADIANA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 JOHNSTON ST STE 200
LAFAYETTE LA
70503-3269
US

IV. Provider business mailing address

2600 JOHNSTON ST
LAFAYETTE LA
70503-3269
US

V. Phone/Fax

Practice location:
  • Phone: 337-232-1234
  • Fax:
Mailing address:
  • Phone: 337-232-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number
License Number StateLA
# 5
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number StateLA

VIII. Authorized Official

Name: STACY MISTRIC
Title or Position: CEO
Credential:
Phone: 337-237-1234