NPIMap

Organization Active NPI

Acadiana Region Supports & Services Center

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Eunice, LA
National Provider Identifier
1891835864
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
950 Issued in LA
Legal business name
ACADIANA REGION SUPPORTS & SERVICES CENTER
Practice address
850 West Park Ave
Eunice, LA 70535
Phone
(337) 821-9301
Fax
(337) 821-9306
NPI assigned
Feb 7, 2007
Last updated
Oct 17, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
ACADIANA REGION SUPPORTS & SERVICES CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Samuel K McDaniel
Title
Mr DD Regional Administrator
Phone
(337) 824-6250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 950 LA Primary

Addresses

Primary practice location

850 West Park Ave
Eunice, LA 70535

Mailing address

224 Gremillion Circle
Iota, LA 70543
Phone (337) 824-6250

Other identifiers 1

IdentifierTypeStateIssuer
1725072MedicaidLA

Other names 1

  • PARK AVENUE COMMUNITY HOME Other name

National Provider Directory

National Provider Directory
Tax ID family
Acadiana Region Supports and Services Center19 organizations share this tax ID, including this one
Part of
Acadiana Region Supports and Services Center

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1891835864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 GREMILLION CIRCLE",
            "city": "IOTA",
            "state": "LA",
            "postal_code": "70543",
            "telephone_number": "337-824-6250",
            "fax_number": "337-821-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 WEST PARK AVE",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "70535",
            "telephone_number": "337-821-9301",
            "fax_number": "337-821-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADIANA REGION SUPPORTS & SERVICES CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACADIANA REGION SUPPORTS & SERVICES CENTER",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MR DD REGIONAL ADMINISTRATOR",
        "authorized_official_telephone_number": "337-824-6250",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1725072",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARK AVENUE COMMUNITY HOME",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eunice, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.