Assisi Bridge House Independent Living Program

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

2437 Issued in LA

Legal business name

ASSISI BRIDGE HOUSE INDEPENDENT LIVING PROGRAM

Practice address

700 Levron St Apt 12D
Houma, LA 70360-5574

Phone

(985) 872-5529

Fax

(985) 857-8270

NPI assigned

Feb 27, 2012

Last updated

Feb 27, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

CATHOLIC CHARITIES OF THE DIOCESE OF HOUMA-THIBODAUXAs reported in NPPES

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

Authorized official

Name

Mr. Robert Damien Gorman, LCSW, ACSW

Title

Executive Director

Phone

(985) 876-0490

Specialties & licenses 1

Addresses

Tax ID family

Assisi Bridge House Independent Living Program2 organizations share this tax ID, including this one

Part of

Assisi Bridge House Independent Living Program

Other organizations with this tax ID 1

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

• Assisi Bridge House

  • Substance Abuse Rehabilitation Facility
  • Schriever, LA
  • NPI 1922370782
  NPD tax ID

Locations

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330300800000",
    "number": "1881968519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 AYCOCK ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703606402",
            "telephone_number": "985-876-0490",
            "fax_number": "985-876-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LEVRON ST APT 12D",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703605574",
            "telephone_number": "985-872-5529",
            "fax_number": "985-857-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSISI BRIDGE HOUSE INDEPENDENT LIVING PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CATHOLIC CHARITIES OF THE DIOCESE OF HOUMA-THIBODAUX",
        "enumeration_date": "2012-02-27",
        "last_updated": "2012-02-27",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DAMIEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "985-876-0490",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW, ACSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "LA",
            "license": "2437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaina Leigh Arp, M.S.S.W.
• Artis Beatty a Professional Optometry Corporation (MyEyeDr.)
• Arunavathi T. Sangisetty, M.D., Apmc
• Ascent Health, Inc
• Ramal Asim, MD
• Assisted Living Concepts Inc (Terrebonne House)
• Amanda Aten
• Erika Aucoin, LOUISIANA 6353
• Joshua E Aucoin, OTR/L
• Audubon Pediatrics, LLC

• Substance Abuse Rehabilitation Facility in Houma, LA
• Providers in Houma, LA by specialty
• Substance Abuse Rehabilitation Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; 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.