Healthcare Provider Details

I. General information

NPI: 1427045020
Provider Name (Legal Business Name): LAFOURCHE HOME FOR THE AGED & INFIRM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 TIGER DR
THIBODAUX LA
70301-6634
US

IV. Provider business mailing address

1002 TIGER DR
THIBODAUX LA
70301-6634
US

V. Phone/Fax

Practice location:
  • Phone: 985-447-2205
  • Fax: 985-446-9977
Mailing address:
  • Phone: 985-447-2205
  • Fax: 985-446-9977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number129
License Number StateLA

VIII. Authorized Official

Name: MRS. ANN H. HOWELL
Title or Position: ADMINISTRATOR
Credential:
Phone: 985-447-2205