Healthcare Provider Details

I. General information

NPI: 1811787229
Provider Name (Legal Business Name): LAFOURCHE OPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 TIGER DR
THIBODAUX LA
70301-6634
US

IV. Provider business mailing address

2431 S ACADIAN THRUWAY STE 100
BATON ROUGE LA
70808-2300
US

V. Phone/Fax

Practice location:
  • Phone: 985-447-2205
  • Fax:
Mailing address:
  • Phone: 225-800-4954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. VICTOR D. GUM
Title or Position: MANAGER
Credential:
Phone: 225-346-8815