Provider Demographics
NPI:1417094384
Name:LAFOURCHE PARISH SCHOOL BOARD LA
Entity Type:Organization
Organization Name:LAFOURCHE PARISH SCHOOL BOARD LA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:BENOIT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:985-435-4621
Mailing Address - Street 1:PO BOX 879
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-0879
Mailing Address - Country:US
Mailing Address - Phone:985-446-5631
Mailing Address - Fax:985-446-0801
Practice Address - Street 1:805 EAST 7TH STREET
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301
Practice Address - Country:US
Practice Address - Phone:985-446-5631
Practice Address - Fax:985-446-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
Not Answered163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Not Answered164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1415472Medicaid
LA1701351OtherMEDICAID