Healthcare Provider Details

I. General information

NPI: 1023151677
Provider Name (Legal Business Name): ASSOC FOR RETARDED CITIZENS OUACHITA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 N 4TH ST
MONROE LA
71201-5909
US

IV. Provider business mailing address

PO BOX 1462
MONROE LA
71210-1462
US

V. Phone/Fax

Practice location:
  • Phone: 318-387-7817
  • Fax: 318-322-0914
Mailing address:
  • Phone: 318-387-7817
  • Fax: 318-322-0914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number11371
License Number StateLA

VIII. Authorized Official

Name: MS. CRAIG RAMBIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 318-387-7817