NPIMap

Organization Active NPI

Beauregard Arc

Doing business as Beaueregard Association for Retarded Citizens Inc

  • Developmental Disabilities Clinic/Center
  • Deridder, LA
National Provider Identifier
1902889991
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
BEAUREGARD ARC
Doing business as
Beaueregard Association for Retarded Citizens Inc
Practice address
1209 W Shirley St
Deridder, LA 70634
Phone
(337) 462-2513
Fax
(337) 462-2513
NPI assigned
Nov 22, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jackie Lynn Hickman
Title
Executive Director
Phone
(337) 462-2513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X NU Primary

Addresses

Primary practice location

1209 W Shirley St
Deridder, LA 70634

Mailing address

1209 W Shirley St
PO Box 13
Deridder, LA 70634
Phone (337) 462-2513

Other names 1

  • Beaueregard Association for Retarded Citizens Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beauregard Arc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902889991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 W SHIRLEY ST",
            "address_2": "PO BOX 13",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "70634",
            "telephone_number": "337-462-2513",
            "fax_number": "337-462-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W SHIRLEY ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "70634",
            "telephone_number": "337-462-2513",
            "fax_number": "337-462-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUREGARD ARC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "337-462-2513",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaueregard Association for Retarded Citizens Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deridder, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.