=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649914763
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TECHE ACTION BOARD, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2022
-----------------------------------------------------
Last Update Date | 08/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22187 HIGHWAY 20
-----------------------------------------------------
City | VACHERIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70090-3621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 225-258-4980
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1115 WEBER ST
-----------------------------------------------------
City | FRANKLIN
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70538-4124
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-828-2550
-----------------------------------------------------
Fax | 337-355-2333
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRIVILEGING & CREDENTIALING MANAGER
-----------------------------------------------------
Name | SHANNON VERDUN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 337-828-2550
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QF0400X
-----------------------------------------------------
Taxonomy Name | Federally Qualified Health Center (FQHC)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------