# THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Thibodaux Regional Work Site Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770241507
- **Authorized official:** KIM LEGENDRE BOUDREAUX (CONTRACT MANAGER)
- **Authorized official phone:** (985) 493-4907

## Contact information

- **Practice address:** 400 N ACADIA RD, THIBODAUX, LA 70301-4856
- **Practice address phone:** (985) 493-4004
- **Mailing address:** 602 N ACADIA RD, THIBODAUX, LA 70301-4823
- **Mailing address phone:** (985) 493-4740
- **Mailing address fax:** (985) 449-2585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 136A00000X | Registered Dietetic Technician | — | NULL | — |
| 136A00000X | Registered Dietetic Technician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/29/2021
- **Last updated:** 05/09/2024