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Acadian Holistic Services LLC

Clinic/Center, Mental Health (Including Community Mental Health Center) in Lake Charles, LA. Organization (NPI-2).

NPI number1275240228
StatusActive
Last updated in NPPESJun 5, 2023

Details

NPI
1275240228
Entity type
Organization (NPI-2)
Legal business name
Acadian Holistic Services LLC
Organization subpart
No
Enumeration date
Oct 31, 2022
Certification date
Jun 5, 2023
Last updated
Jun 5, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes
251S00000X Community/Behavioral Health––
251B00000X Case Management––

Practice location

2829 4th Ave Ste 215
Lake Charles, LA 70601-7887

Phone 337-707-3872

Mailing address

2829 4th Ave # 215
Lake Charles, LA 70601-7887

Phone 337-429-5105 · Fax 337-888-9853

Authorized official

Michael Johnson
Program Administrator/Owner
3377073872

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