Healthcare Provider Details

I. General information

NPI: 1801016985
Provider Name (Legal Business Name): THE ARC OF IBERIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3716 REDWOOD DR
NEW IBERIA LA
70560-3379
US

IV. Provider business mailing address

1201 BRASHEAR AVE SUITE 334
MORGAN CITY LA
70380-1361
US

V. Phone/Fax

Practice location:
  • Phone: 337-367-6813
  • Fax: 337-367-6908
Mailing address:
  • Phone: 337-367-6813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberPCA 6717
License Number StateLA

VIII. Authorized Official

Name: KENNY PATTON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 337-367-6813