MEDICARE: PEDIAKARE DE LOUSIANA

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	261Q00000X	Clinic/Center		LA
2	261QM3000X	Medically Fragile Infants and Children Day Care

General Provider Information

NPI Number	:	1467710608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIAKARE DE LOUSIANA

Provider Business Mailing Address
First Line	:	4011 MOSS ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70507-4119
Country	:	US
Telephone Number	:	337-269-5505
Fax Number	:	337-269-5506

Provider Business Practice Location Address
First Line	:	4011 MOSS ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70507-4119
Country	:	US
Telephone Number	:	337-269-5505
Fax Number	:	337-269-5506

Authorized Official
Title or Position	:	OWNER
Name	:	MS. SHERITA MARIE NARCISSE
Credential	:
Telephone Number	:	337-269-5505

Provider Enumeration Date	:	04/25/2012
Last Update Date	:	06/25/2025

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1982604419 — DR. PATRICK DEVINCENT MOORE M.D.
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1295728749 — GERARD K WILLIAMS MD
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1760476196 — MS. AMY E VENABLE ATC,LAT
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Directions to “PEDIAKARE DE LOUSIANA ” Practice Location

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