Organization
THIBODEAUX & ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN THIBODEAUX III LAC (DIRECTOR)
(504) 450-1182
Entity
Organization
Contact information
Practice address
4700 FRERET ST, NEW ORLEANS, LA 70115-6321
(504) 450-1182
Mailing address
4117 S DERBIGNY ST, NEW ORLEANS, LA 70125-4631
(504) 450-1182
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
971
LA
Other
Enumeration date
07/08/2011
Last updated
07/08/2011
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