Organization
LIFE COAST COMMUNITY HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON BOUDREAUX (CEO)
(985) 492-6170
Entity
Organization
Contact information
Practice address
504 N ACADIA RD, THIBODAUX, LA 70301-4862
(985) 492-6170
(985) 492-6177
Mailing address
504 N ACADIA RD, THIBODAUX, LA 70301-4862
(985) 492-6170
(985) 492-6177
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/09/2022
Last updated
07/16/2026
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