Acidom Medical Services II LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ACIDOM MEDICAL SERVICES II LLC

Practice address

3864 Deercreek LN
Harvey, LA 70058-2115

Phone

(504) 296-3365

Fax

(504) 340-8884

NPI assigned

Mar 28, 2016

Last updated

Mar 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roxanne Modica

Title

Owner

Phone

(504) 296-3365

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459123200000",
    "number": "1902268980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3864 DEERCREEK LN",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700582115",
            "telephone_number": "504-296-3365",
            "fax_number": "504-340-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3864 DEERCREEK LN",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700582115",
            "telephone_number": "504-296-3365",
            "fax_number": "504-340-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACIDOM MEDICAL SERVICES II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-28",
        "last_updated": "2016-03-28",
        "status": "A",
        "authorized_official_last_name": "MODICA",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-296-3365"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.