Organization · Type 2 NPI

Acadiana Region Supports & Services Center

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Jennings, LA

NPI number 1962542910 Active

Practice location

1103 N Church St
Jennings, LA 70546-4707

Call (337) 821-9301 Map

Fax (337) 821-9306

Mailing address

224 Gremillion Circle
Iota, LA 70543

Specialties and licenses

Taxonomy	Code	License
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	279 (LA)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Other intellectual and/or developmental disabilities community based residential treatment facility providers in Jennings

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NPI record

NPI: 1962542910
Entity type: Organization (Type 2)
Issued: Feb 7, 2007
Last updated: Oct 17, 2007
Status: Active
Subpart: Yes of Acadiana Region Supports & Services Center

Other names

<unavail>
Church ST Community Home · other name

Authorized official

Mr. Samuel K McDaniel
MR DD Regional Administrator
(337) 824-6250

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1962542910

Acadiana Region Supports & Services Center's National Provider Identifier is 1962542910, issued on Feb 7, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Jennings, LA. The record was last updated on Oct 17, 2007.