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NPI Code Detail

MEDICARE: TRIUMPHANT SERVICES OF LOUISIANA

MEDICARE: TRIUMPHANT SERVICES OF LOUISIANA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
21223G0001XGeneral Practice Dentistry
3363LP0808XPsychiatric/Mental Health Nurse Practitioner
4261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1679106421
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRIUMPHANT SERVICES OF LOUISIANA
Provider Business Mailing Address
First Line : 330 GUIDRY ST.
Second Line :
City : LAFAYETTE
State : LA
Zip : 70501
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 330 GUIDRY STREET
Second Line :
City : LAFAYETTE
State : LA
Zip : 70501
Country : US
Telephone Number : 337-962-9049
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MARCUS BRUNO
Credential :
Telephone Number : 337-962-9049
Provider Enumeration Date : 02/20/2020
Last Update Date : 12/16/2025

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Directions to “TRIUMPHANT SERVICES OF LOUISIANA ” Practice Location

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