Provider Demographics
NPI:1699881847
Name:LTAC OF ACADIANA
Entity type:Organization
Organization Name:LTAC OF ACADIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HAMPTON
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-769-2036
Mailing Address - Street 1:310 YOUNGSVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-4524
Mailing Address - Country:US
Mailing Address - Phone:337-839-9880
Mailing Address - Fax:337-769-1545
Practice Address - Street 1:310 YOUNGSVILLE HWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4524
Practice Address - Country:US
Practice Address - Phone:337-839-9880
Practice Address - Fax:337-769-1545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA591282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA192029Medicare Oscar/Certification