1659300325 NPI number — ACADIANA AREA HUMAN SERVICES DISTRICT

Table of content: (NPI 1659300325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659300325 NPI number — ACADIANA AREA HUMAN SERVICES DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACADIANA AREA HUMAN SERVICES DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CROWLEY BEHAVIORAL HEALTH ADDICTIVE DISORDERS CLINIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659300325
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1822 W 2ND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CROWLEY
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70526-4720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-788-7511
Provider Business Mailing Address Fax Number:
337-788-7588

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1822 W 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CROWLEY
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70526-4720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-788-7511
Provider Business Practice Location Address Fax Number:
337-788-7588
Provider Enumeration Date:
07/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KNOWLES
Authorized Official First Name:
CAROLYN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
MENTAL HEALTH CENTER MANAGER B
Authorized Official Telephone Number:
337-788-7511

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  CCGC# 23 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: BCSAC# 478 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: LAC# 1070 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: LAC# 672 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: CCGC# 1003 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: GSW# 6111 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WA0400X , with the licence number: RN079104 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: 482 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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