Healthcare Provider Details

I. General information

NPI: 1811372527
Provider Name (Legal Business Name): SOUTH CENTRAL LOUISIANA HUMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2015
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 BARROW ST
HOUMA LA
70360-4722
US

IV. Provider business mailing address

158 REGAL ROW
HOUMA LA
70360-6097
US

V. Phone/Fax

Practice location:
  • Phone: 985-857-3615
  • Fax: 985-426-6128
Mailing address:
  • Phone: 985-857-3748
  • Fax: 985-858-2934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISTY HEBERT
Title or Position: DEPUTY DIRECTOR
Credential:
Phone: 985-858-2931