Organization
COMMUNITY CARE CENTER OF THIBODAUX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONI PARKINSON (AUTHORIZED REPRESENTATIVE)
(601) 709-1408
Entity
Organization
Contact information
Practice address
2110 AUDUBON AVE, THIBODAUX, LA 70301-5014
(985) 446-3975
(985) 447-5329
Mailing address
2110 AUDUBON AVE, THIBODAUX, LA 70301-5014
(985) 446-3975
(985) 447-5329
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
766
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1521311
—
LA
Enumeration date
04/28/2006
Last updated
11/30/2024
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