NPIMap

Organization Active NPI

Bayou Region Supports & Services Center

  • Intellectual Disabilities Intermediate Care Facility
  • Thibodaux, LA
National Provider Identifier
1730348608
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
1024 Issued in LA
Legal business name
BAYOU REGION SUPPORTS & SERVICES CENTER
Practice address
690 E 1St St
Thibodaux, LA 70301-3546
Phone
(980) 449-5181
Fax
(985) 449-5198
NPI assigned
Jun 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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

Authorized official

Name
Mrs. Janelle Folse
Title
Regional Assoc. Administrator Mrdd2
Phone
(985) 449-5181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 1024 LA Primary

Addresses

Primary practice location

690 E 1St St
Thibodaux, LA 70301-3546

Mailing address

690 E 1St St
Thibodaux, LA 70301-3546
Phone (980) 449-5181

Other identifiers 1

IdentifierTypeStateIssuer
1312428MedicaidLA

Other names 1

  • Fairway Community Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peltier - Lawless Developmental Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1730348608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 E 1ST ST",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703013546",
            "telephone_number": "980-449-5181",
            "fax_number": "985-449-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 E 1ST ST",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703013546",
            "telephone_number": "980-449-5181",
            "fax_number": "985-449-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYOU REGION SUPPORTS & SERVICES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "FOLSE",
        "authorized_official_first_name": "JANELLE",
        "authorized_official_title_or_position": "REGIONAL ASSOC. ADMINISTRATOR MRDD2",
        "authorized_official_telephone_number": "985-449-5181",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "LA",
            "license": "1024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1312428",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairway Community Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 20, 2008; 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.