# TRPP-ACO LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THIBODAUX REGIONAL HEALTH SYSTEM INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1295309029
- **Legal business name:** THIBODAUX REGIONAL HEALTH SYSTEM INC
- **Authorized official:** KIM LEGENDRE BOUDREAUX MBA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (985) 449-2585

## Contact information

- **Practice address:** 602 N. ACADIA ROAD, THIBODAUX, LA 70301
- **Practice address phone:** (985) 493-4907
- **Practice address fax:** (985) 449-2585
- **Mailing address:** 602 N. ACADIA ROAD, THIBODAUX, LA 70301
- **Mailing address phone:** (985) 493-4907
- **Mailing address fax:** (985) 493-2585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 05/17/2021
- **Last updated:** 05/17/2021