Healthcare Provider Details

I. General information

NPI: 1629980768
Provider Name (Legal Business Name): MRS. JACHARIA ANN ARCENEAUX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CEZANNE DR
RAYNE LA
70578-2745
US

IV. Provider business mailing address

200 CEZANNE DR
RAYNE LA
70578-2745
US

V. Phone/Fax

Practice location:
  • Phone: 337-205-1645
  • Fax:
Mailing address:
  • Phone: 337-205-1645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number009100647
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: