NPIMap

Organization Active NPI

Lafourche Arc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Thibodaux, LA
National Provider Identifier
1366594863
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
6791 Issued in LA
Legal business name
LAFOURCHE ARC
Practice address
100 W Main St
Thibodaux, LA 70301-5216
Phone
(985) 447-6214
Fax
(985) 447-4813
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ricky Bonvillain
Title
Fiscal Services Director
Phone
(985) 447-6214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 6791 LA Primary

Addresses

Primary practice location

100 W Main St
Thibodaux, LA 70301-5216

Mailing address

100 W Main St
Thibodaux, LA 70301-5216
Phone (985) 447-6214

Other identifiers 1

IdentifierTypeStateIssuer
1950319MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Lafourche Arc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366594863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W MAIN ST",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015216",
            "telephone_number": "985-447-6214",
            "fax_number": "985-447-4813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W MAIN ST",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015216",
            "telephone_number": "985-447-6214",
            "fax_number": "985-447-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFOURCHE ARC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BONVILLAIN",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "FISCAL SERVICES DIRECTOR",
        "authorized_official_telephone_number": "985-447-6214"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "6791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1950319",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.