Lafourche Arc

NPI 1043362692 - Intermediate Care Facility, Mentally Retarded - 315P00000X

NPI Details
NPI 1043362692
Enumeration Date 01/16/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name RICKY RICKY
Position FISCAL SERVICES DIRECTOR
Phone (985) 447-6214
Fax (985) 447-4813
Practice Location
100 W MAIN ST
THIBODAUX LA, 70301-5216, US
Phone (985) 447-6214
Fax (985) 447-4813
Business Location
100 W MAIN ST
THIBODAUX LA, 70301-5216, US
Phone (985) 447-6214
Fax (985) 447-4813
Toxanomy
Taxonomy Code 315P00000X
License State Louisiana
License Number 351
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According to our database, Lafourche Arc NPI is 1043362692, taxonomy code is 315P00000X and license number is 351, license state is located at Louisiana. Lafourche Arc physically located at 100 W Main St, Thibodaux LA, 70301-5216. NPI Number 1033115704 has the healthcare provider type.

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1043362692 NPI number is provided on an as is basis without warranty of any kind. 1043362692 is maintained by the National Plan & Provider Enumeration System. The contents of Lafourche Arc are for informational purposes only.