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Organization
BAYOU REGION SUPPORTS & SERVICES CENTER
Active
Organization
BAYOU REGION SUPPORTS & SERVICES CENTER
Active
Other names
Fairway Community Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANELLE FOLSE (REGIONAL ASSOC. ADMINISTRATOR MRDD2)
(985) 449-5181
Entity
Organization
Contact information
Practice address
690 E 1ST ST, THIBODAUX, LA 70301-3546
(980) 449-5181
(985) 449-5198
Mailing address
690 E 1ST ST, THIBODAUX, LA 70301-3546
(980) 449-5181
(985) 449-5198
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
1024
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1312428
—
LA
Enumeration date
06/05/2008
Last updated
10/20/2008
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