NPI 1043362692

Lafourche Arc

Organisation Intellectual Disabilities Intermediate Care Facility Thibodaux, LA

Practice location

Address: 100 W Main St, Thibodaux, LA 70301-5216
Phone: (985) 447-6214
Fax: (985) 447-4813

Authorised official

Name: Ricky Bonvillain
Title: Fiscal Services Director
Phone: (985) 447-6214

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 351 (LA)

Other Intermediate Care Facility, Intellectual Disabilities providers in Louisiana →

Registry record

NPI: 1043362692
Entity type: Organization
NPI issued: 16 Jan 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.