Healthcare Provider Details

I. General information

NPI: 1417050634
Provider Name (Legal Business Name): THE ARC OF ST. MARTIN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LELIA ST
SAINT MARTINVILLE LA
70582-4109
US

IV. Provider business mailing address

PO BOX 128
SAINT MARTINVILLE LA
70582-0128
US

V. Phone/Fax

Practice location:
  • Phone: 337-394-4928
  • Fax: 337-394-5974
Mailing address:
  • Phone: 337-394-4928
  • Fax: 337-394-5974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number5239
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number558
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number559
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number7296
License Number StateLA
# 5
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number5021
License Number StateLA

VIII. Authorized Official

Name: MRS. KERRIE A LATIOLAIS
Title or Position: DIRECTOR
Credential:
Phone: 337-394-4928