Healthcare Provider Details

I. General information

NPI: 1982985776
Provider Name (Legal Business Name): A & L ADULT DAY HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2011
Last Update Date: 09/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 W ADMIRAL DOYLE DR A
NEW IBERIA LA
70560-7201
US

IV. Provider business mailing address

435 W MAIN ST B
NEW IBERIA LA
70560-3644
US

V. Phone/Fax

Practice location:
  • Phone: 337-364-7411
  • Fax: 337-364-7842
Mailing address:
  • Phone: 337-364-5551
  • Fax: 337-364-1550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number5077
License Number StateLA

VIII. Authorized Official

Name: MR. ALTON JAMES ANTHONY JR.
Title or Position: PRESIDENT
Credential:
Phone: 337-519-2392