Healthcare Provider Details

I. General information

NPI: 1245164342
Provider Name (Legal Business Name): SOUTHERN HOPE FAMILY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11161 CAMBRE OAKS DR
GONZALES LA
70737-6336
US

IV. Provider business mailing address

11161 CAMBRE OAKS DR
GONZALES LA
70737-6336
US

V. Phone/Fax

Practice location:
  • Phone: 225-532-6615
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANASTATIA THERIOT
Title or Position: OWNER
Credential: LLC
Phone: 985-686-0268