MEDICARE: ACADIAN CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	2736	LA
2	101Y00000X	Counselor	2916	LA
3	2084P0804X	Child & Adolescent Psychiatry Physician	021881	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134256472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACADIAN CARE LLC

Provider Business Mailing Address
First Line	:	113 CHRISTIAN LN
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-1350
Country	:	US
Telephone Number	:	985-781-7353
Fax Number	:	985-781-7354

Provider Business Practice Location Address
First Line	:	113 CHRISTIAN LN
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-1350
Country	:	US
Telephone Number	:	985-781-7353
Fax Number	:	985-781-7354

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RICHARD FREDERICK KUTNER
Credential	:	M.D.
Telephone Number	:	985-781-7353

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	03/11/2015

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Directions to “ACADIAN CARE LLC ” Practice Location

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