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ACADIANA LONG TERM CARE LLC NPI 1588014864


NPI Information

NPI: 1588014864
Provider Name: ACADIANA LONG TERM CARE LLC
Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 19D1005562

Address:
202 WESTGATE RD
LAFAYETTE, LA
ZIP 70506
Phone: (337) 232-1802
Get Directions

ACADIANA LONG TERM CARE LLC is a geriatric medicine family medicine in Lafayette, LA. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. ACADIANA LONG TERM CARE LLC NPI is 1588014864. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

202 WESTGATE RD
LAFAYETTE, LA
ZIP 70506-711
Phone: (337) 232-1802
Fax: (337) 232-1809

The provider's authorized official is Geoffrey A Mire .
The authorized official title is Ceo and has the following contact phone number (337) 232-1802.

The CLIA number assigned to this NPI record is 19D1005562 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/16/2016 and was last updated on 6/16/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QG0300XFamily MedicineGeriatric Medicine025427LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15DE30MEDICARE PINLOUISIANA
21576140MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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