=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417050634
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE ARC OF ST. MARTIN, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 LELIA ST
-----------------------------------------------------
City | SAINT MARTINVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70582-4109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-394-4928
-----------------------------------------------------
Fax | 337-394-5974
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 128
-----------------------------------------------------
City | SAINT MARTINVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70582-0128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-394-4928
-----------------------------------------------------
Fax | 337-394-5974
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MRS. KERRIE A LATIOLAIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 337-394-4928
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number | 5239
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 320600000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
-----------------------------------------------------
License Number | 558
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 320600000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
-----------------------------------------------------
License Number | 559
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 320900000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
-----------------------------------------------------
License Number | 7296
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 320900000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
-----------------------------------------------------
License Number | 5021
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------