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Organization · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Thibodaux, LA

NPI
1992857494
Type
Organization (Type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities)
Specialty group
Residential Treatment Facilities
Taxonomy code
320900000X
License number
6791 (LA)
Enumerated
2007-01-17
Last updated
2020-08-22
Practice location
100 W Main St
Thibodaux, LA 70301-5216
(985) 447-6214

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