Healthcare Provider Details

I. General information

NPI: 1154330652
Provider Name (Legal Business Name): ST. LANDRY PARISH RURAL HEALTH NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 E VINE ST
OPELOUSAS LA
70570-5152
US

IV. Provider business mailing address

PO BOX 2234
OPELOUSAS LA
70571-2234
US

V. Phone/Fax

Practice location:
  • Phone: 337-942-2880
  • Fax: 337-942-6367
Mailing address:
  • Phone: 337-942-2880
  • Fax: 337-942-6367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberCM 6651
License Number StateLA

VIII. Authorized Official

Name: MRS. DODIE LAMOTT
Title or Position: CHAIRMAN OF THE BOARD
Credential:
Phone: 337-942-2005