Organization
PROGRESSIVE ACUTE CARE DAUTERIVE, LLC
Active
Organization
PROGRESSIVE ACUTE CARE DAUTERIVE, LLC
Active
Other names
DAUTERIVE HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE THOMPSON (CFO)
(985) 624-7401
Entity
Organization
Contact information
Practice address
600 N LEWIS ST, NEW IBERIA, LA 70563-2043
(337) 365-7311
(337) 374-4104
Mailing address
600 N LEWIS ST, NEW IBERIA, LA 70563-2043
(337) 365-7311
(337) 374-4104
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61026
BCBS-PSYCH
LA
Enumeration date
05/18/2006
Last updated
07/08/2013
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