# THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Thibodaux Regional Weight Management Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831942689
- **Authorized official:** KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
- **Authorized official phone:** (985) 493-4907

## Contact information

- **Practice address:** 604 N ACADIA RD, STE 406, THIBODAUX, LA 70301-4897
- **Practice address phone:** (985) 493-4130
- **Practice address fax:** (985) 493-4131
- **Mailing address:** 602 NORTH ACADIA ROAD, CONTRACT MANAGEMENT DEPT., THIBODAUX, LA 70301
- **Mailing address phone:** (985) 493-4907
- **Mailing address fax:** (985) 449-2585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | — | — | Yes |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 04/10/2024
- **Last updated:** 04/24/2026