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General NPI Number Information
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NPI Number | 1518455344
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Entity Type | Organization
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Legal Business Name | ACADIA SENIOR CARE, LLC
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 702 N POLK ST
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City | RAYNE
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State | LA
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Zip | 70578-6022
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Country | US
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Telephone | 337-334-0111
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Fax | 337-427-5007
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Provider Business Mailing Address
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Address Line | 702 N POLK ST
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City | RAYNE
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State | LA
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Zip | 70578-6022
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Country | US
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Telephone | 337-334-0111
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Fax | 337-427-5007
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. MICHAEL SCOTT NORMAND
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Credential |
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Telephone | 337-334-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 2203783889
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License Number State | LA
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