Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Network Development Corporation Geri Psyc
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE GAUBERT (AGENT)
(985) 493-4721
Entity
Organization
Contact information
Practice address
602 N ACADIA RD, THIBODAUX, LA 70301-4847
(985) 447-5500
Mailing address
PO BOX 5478, THIBODAUX, LA 70302-5478
(985) 447-5500
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2325060
—
LA
Enumeration date
10/03/2012
Last updated
12/07/2016
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