| Acadiana Long Term Care Llc | |
|
202 Westgate Rd Lafayette LA 70506-2711 | |
| (337) 232-1802 | |
| (337) 232-1809 |
| Full Name | Acadiana Long Term Care Llc |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 202 Westgate Rd, Lafayette, Louisiana |
| Authorized Official Name and Position | Geoffrey A Mire (CEO) |
| Authorized Official Contact | 3372321802 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Acadiana Long Term Care Llc 202 Westgate Rd Lafayette LA 70506-2711 Ph: (337) 232-1802 | Acadiana Long Term Care Llc 202 Westgate Rd Lafayette LA 70506-2711 Ph: (337) 232-1802 |
| NPI Number | 1588014864 |
|---|---|
| Provider Enumeration Date | 06/16/2016 |
| Last Update Date | 06/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588014864 | NPI | - | NPPES |
| 1576140 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | 025427 (Louisiana) | Primary |
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